Provider Demographics
NPI:1922611565
Name:RAHMANIAN, KIARASH PETER (MPH, MHS)
Entity Type:Individual
Prefix:MR
First Name:KIARASH
Middle Name:PETER
Last Name:RAHMANIAN
Suffix:
Gender:M
Credentials:MPH, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CENTRAL CAROLINA HOSPITAL - EMERGENCY MEDICINE
Mailing Address - Street 2:1135 CARTHAGE STREET
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4162
Mailing Address - Country:US
Mailing Address - Phone:404-961-6601
Mailing Address - Fax:
Practice Address - Street 1:CENTRAL CAROLINA HOSPITAL - EMERGENCY MEDICINE
Practice Address - Street 2:1135 CARTHAGE STREET
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4162
Practice Address - Country:US
Practice Address - Phone:404-961-6601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC390200000X
NC0010-10665363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0010-10665OtherNC MEDICAL LICENSE