Healthcare Provider Details

I. General information

NPI: 1730462342
Provider Name (Legal Business Name): BEST CARE INTERNAL MEDICINE AND PEDIATRICS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2011
Last Update Date: 09/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3214 CHARLES B ROOT WYND SUITE 213
RALEIGH NC
27612-5440
US

IV. Provider business mailing address

3214 CHARLES B ROOT WYND SUITE 213
RALEIGH NC
27612-5440
US

V. Phone/Fax

Practice location:
  • Phone: 919-781-8787
  • Fax: 919-781-8782
Mailing address:
  • Phone: 919-781-8787
  • Fax: 919-781-8782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number200400517
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number200400517
License Number StateNC

VIII. Authorized Official

Name: DR. DABIRUDDIN M HUMAYUN
Title or Position: OWNER
Credential: MD
Phone: 919-781-8787