Healthcare Provider Details

I. General information

NPI: 1508350919
Provider Name (Legal Business Name): PARSA RAIS GHASEM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2018
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2310 ERWIN ROAD
DURHAM NC
27710-5000
US

IV. Provider business mailing address

2310 ERWIN ROAD
DURHAM NC
27710-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-8111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2021-00404
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4301114663
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number202100404
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: