Healthcare Provider Details

I. General information

NPI: 1942120092
Provider Name (Legal Business Name): ELITE ROXBORO PRIMARY CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

783 DOCTORS CT STE A
ROXBORO NC
27573-4571
US

IV. Provider business mailing address

1908 STANNARD TRL
RALEIGH NC
27612-6398
US

V. Phone/Fax

Practice location:
  • Phone: 814-937-6099
  • Fax:
Mailing address:
  • Phone: 814-937-6099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SAFWAT NASRAT
Title or Position: CMO, CEO, OWNER
Credential: MD
Phone: 814-937-6099