Provider Demographics
NPI:1821222571
Name:CAROLINA RHEUMATOLOGY & INTERNAL MEDICINE, PA
Entity Type:Organization
Organization Name:CAROLINA RHEUMATOLOGY & INTERNAL MEDICINE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-920-1450
Mailing Address - Street 1:2356 JOHN SMITH RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-2618
Mailing Address - Country:US
Mailing Address - Phone:910-920-1450
Mailing Address - Fax:910-920-1864
Practice Address - Street 1:2356 JOHN SMITH RD
Practice Address - Street 2:SUITE 101
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-2618
Practice Address - Country:US
Practice Address - Phone:910-920-1450
Practice Address - Fax:910-920-1864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-01588207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty