Healthcare Provider Details

I. General information

NPI: 1336645431
Provider Name (Legal Business Name): ARUN AJMERA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2018
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 PRATT ST
DURHAM NC
27705-3976
US

IV. Provider business mailing address

2400 PRATT ST
DURHAM NC
27705-3976
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-5068
  • Fax: 919-684-4836
Mailing address:
  • Phone: 919-684-5068
  • Fax: 919-684-4836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number2024-00910
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: