Provider Demographics
NPI:1346247756
Name:VIAS, PINAKIN PUSHKARRAI (MD)
Entity Type:Individual
Prefix:
First Name:PINAKIN
Middle Name:PUSHKARRAI
Last Name:VIAS
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 1:4384 FAYETTEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-2677
Mailing Address - Country:US
Mailing Address - Phone:910-738-1141
Mailing Address - Fax:910-738-1142
Practice Address - Street 1:4384 FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2677
Practice Address - Country:US
Practice Address - Phone:910-738-1141
Practice Address - Fax:910-738-1142
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8506YOtherBCBS
NC898506YMedicaid
NC2232872CMedicare ID - Type Unspecified
NC898506YMedicaid