Provider Demographics
NPI:1245204700
Name:NORTH RALEIGH GASTROENTEROLOGY, P.A.
Entity Type:Organization
Organization Name:NORTH RALEIGH GASTROENTEROLOGY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJAT
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-846-9011
Mailing Address - Street 1:PO BOX 98629
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27624-8629
Mailing Address - Country:US
Mailing Address - Phone:919-846-9011
Mailing Address - Fax:844-587-9567
Practice Address - Street 1:7560 CARPENTER FIRE STATION RD STE 303A
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-9637
Practice Address - Country:US
Practice Address - Phone:919-846-9011
Practice Address - Fax:844-587-9567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400030207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891008PMedicaid
G23926Medicare UPIN
NC2221946Medicare ID - Type Unspecified