Provider Demographics
NPI:1659409944
Name:ROWAN PRIMARY CARE, PC
Entity Type:Organization
Organization Name:ROWAN PRIMARY CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PARINDA
Authorized Official - Middle Name:KANAIYALAL
Authorized Official - Last Name:FRUCHTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-639-0407
Mailing Address - Street 1:1406A W INNES ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2502
Mailing Address - Country:US
Mailing Address - Phone:704-639-0407
Mailing Address - Fax:704-639-9599
Practice Address - Street 1:1406A W INNES ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2502
Practice Address - Country:US
Practice Address - Phone:704-639-0407
Practice Address - Fax:704-639-9599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890208LMedicaid
NC2322384Medicare PIN