Provider Demographics
NPI:1194839811
Name:AMIN, RAAJ (MD)
Entity Type:Individual
Prefix:
First Name:RAAJ
Middle Name:
Last Name:AMIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6912 FINIAN DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-2685
Mailing Address - Country:US
Mailing Address - Phone:910-207-0777
Mailing Address - Fax:910-202-6312
Practice Address - Street 1:27417 ANDREW JACKSON HIGHWAY EAST
Practice Address - Street 2:
Practice Address - City:DELCO
Practice Address - State:NC
Practice Address - Zip Code:28436
Practice Address - Country:US
Practice Address - Phone:910-207-0777
Practice Address - Fax:910-202-6312
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200632208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC131PJOtherBCBS NC
NC89131PJMedicaid
NCB7908OtherMEDCOST
NC1201081OtherUHC
NC561980160X10OtherCIGNA
NC89131PJMedicaid
NC89131PJMedicaid