Healthcare Provider Details

I. General information

NPI: 1609121615
Provider Name (Legal Business Name): CAROLINA VEIN INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2012
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2245 GATEWAY ACCESS PT STE 315
RALEIGH NC
27607-3078
US

IV. Provider business mailing address

2245 GATEWAY ACCESS PT STE 315
RALEIGH NC
27607-3078
US

V. Phone/Fax

Practice location:
  • Phone: 919-510-8900
  • Fax: 919-510-8977
Mailing address:
  • Phone: 919-510-8900
  • Fax: 919-510-8977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: LUAN VAN TRAN
Title or Position: OWNER AND PHYSICIAN
Credential:
Phone: 919-510-8900