Healthcare Provider Details

I. General information

NPI: 1376123471
Provider Name (Legal Business Name): PARTH R VAIDYA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2351 ERWIN RD
DURHAM NC
27705-4699
US

IV. Provider business mailing address

2351 ERWIN RD
DURHAM NC
27705-4699
US

V. Phone/Fax

Practice location:
  • Phone: 919-681-3937
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number2026-01727
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: