Healthcare Provider Details

I. General information

NPI: 1013304963
Provider Name (Legal Business Name): NICHOLAS PARRISH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2015
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ERWIN RD
DURHAM NC
27710-2730
US

IV. Provider business mailing address

2301 ERWIN RD DUMC BOX 3522
DURHAM NC
27710-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-613-6133
  • Fax: 919-684-8716
Mailing address:
  • Phone: 919-613-6133
  • Fax: 919-684-8716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2024-01973
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number56273
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: