Provider Demographics
NPI:1689898041
Name:SANFORD CARE INTERNAL MEDICINE, P.C.
Entity Type:Organization
Organization Name:SANFORD CARE INTERNAL MEDICINE, P.C.
Other - Org Name:PARINAZ B NASSERI, MD, P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PARINAZ
Authorized Official - Middle Name:B
Authorized Official - Last Name:BARADARAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-776-4040
Mailing Address - Street 1:109 S VANCE ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4372
Mailing Address - Country:US
Mailing Address - Phone:919-776-4040
Mailing Address - Fax:919-776-4043
Practice Address - Street 1:109 S VANCE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4372
Practice Address - Country:US
Practice Address - Phone:919-776-4040
Practice Address - Fax:919-776-4043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200401422207R00000X
NC207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5900715Medicaid
NC141HHOtherBCBS
NC5902806Medicaid
NCI21348Medicare UPIN
NC2332046Medicare ID - Type UnspecifiedMEDICARE
NC5900715Medicaid
NC141HHOtherBCBS