Healthcare Provider Details

I. General information

NPI: 1164326856
Provider Name (Legal Business Name): HARBORMED CARE OF NC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

542 ALLRED MILL RD # M4
MOUNT AIRY NC
27030-2202
US

IV. Provider business mailing address

542 ALLRED MILL RD # M4
MOUNT AIRY NC
27030-2202
US

V. Phone/Fax

Practice location:
  • Phone: 718-709-0940
  • Fax:
Mailing address:
  • Phone: 718-709-0940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: PEYMAN YOUNESI
Title or Position: OWNER
Credential: MD
Phone: 718-709-0940