Healthcare Provider Details

I. General information

NPI: 1548302177
Provider Name (Legal Business Name): AJAY K AJMANI MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 DENNIS DR SUITE 121
SANFORD NC
27330-6343
US

IV. Provider business mailing address

PO BOX 2058
SANFORD NC
27331-2058
US

V. Phone/Fax

Practice location:
  • Phone: 919-774-5911
  • Fax: 919-774-5957
Mailing address:
  • Phone: 919-774-5911
  • Fax: 919-774-5957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. AJAY KUMAR AJMANI
Title or Position: PRESIDENT
Credential: MD
Phone: 919-774-5911