Provider Demographics
NPI:1689614539
Name:VARANASI, SANGEETA C (MD)
Entity Type:Individual
Prefix:
First Name:SANGEETA
Middle Name:C
Last Name:VARANASI
Suffix:
Gender:F
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:PO BOX 18563
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27619-8563
Mailing Address - Country:US
Mailing Address - Phone:919-782-1806
Mailing Address - Fax:919-784-8102
Practice Address - Street 1:530 NEW WAVERLY PL
Practice Address - Street 2:SUITE 200
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7414
Practice Address - Country:US
Practice Address - Phone:919-859-5955
Practice Address - Fax:919-859-3620
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-00479207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902423Medicaid
NC0404175OtherEVERCARE
NCE4640OtherMEDCOST PROVIDER#
NCP00288981OtherPALMETTO GBA PROVIDER#
NC104C5OtherBC/BS NC PROVIDER#
NCFH1020400OtherFIRSTCAROLINACARE PROV.#
SCN79006OtherSC MEDICAID PROVIDER#
I43868Medicare UPIN
NC104C5OtherBC/BS NC PROVIDER#