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NPI Code Detail

MEDICARE: SHOHREH TAAVONI M.D.

MEDICARE: SHOHREH TAAVONI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician38448NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
138448OTHERNCLICENSE

General Provider Information

NPI Number : 1417959560
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHOHREH TAAVONI M.D.
Provider Business Mailing Address
First Line : 2511 OLD CORNWALLIS RD
Second Line : SUITE 200
City : DURHAM
State : NC
Zip : 27713-1869
Country : US
Telephone Number : 919-932-5700
Fax Number : 919-933-6881
Provider Business Practice Location Address
First Line : 2511 OLD CORNWALLIS RD
Second Line : SUITE 200
City : DURHAM
State : NC
Zip : 27713-1869
Country : US
Telephone Number : 919-932-5700
Fax Number : 919-933-6881
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 07/02/2014

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Directions to “ SHOHREH TAAVONI M.D.” Practice Location

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