Healthcare Provider Details

I. General information

NPI: 1568993780
Provider Name (Legal Business Name): HIMANSHU AJRAWAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2017
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ERWIN ROAD
DURHAM NC
27710-1407
US

IV. Provider business mailing address

BOX 3808 DUMC
DURHAM NC
27710-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-7293
  • Fax: 919-684-7151
Mailing address:
  • Phone: 772-607-2669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number2021-01269
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2021-01269
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: