Healthcare Provider Details

I. General information

NPI: 1255693172
Provider Name (Legal Business Name): ALIESE ANAHID SARKISSIAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2012
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 CENTRAL DR
SANFORD NC
27330-4159
US

IV. Provider business mailing address

2000 PERIMETER PARK DR STE 200
MORRISVILLE NC
27560-8442
US

V. Phone/Fax

Practice location:
  • Phone: 919-718-9512
  • Fax: 919-718-9516
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number126255
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number2018-00666
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: