Healthcare Provider Details

I. General information

NPI: 1609366038
Provider Name (Legal Business Name): RAJAN NILESH AMIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2018
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1814 WESTCHESTER DR STE 101
HIGH POINT NC
27262-7369
US

IV. Provider business mailing address

1814 WESTCHESTER DR STE 101
HIGH POINT NC
27262-7369
US

V. Phone/Fax

Practice location:
  • Phone: 336-802-2105
  • Fax: 336-802-2106
Mailing address:
  • Phone: 336-802-2105
  • Fax: 336-802-2106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2025-02823
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number2025-02823
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: