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General NPI Number Information
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NPI Number | 1083144596
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Entity Type | Individual
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Provider Name | TARIG AHMED BERAIMA ELRAIYAH MD
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Gender | Male
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Dates
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Enumeration Date | 06/16/2017
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 511 PALADIN DR
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City | GREENVILLE
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State | NC
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Zip | 27834-7826
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Country | US
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Telephone | 252-752-8880
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Fax | 252-317-2092
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Provider Business Mailing Address
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Address Line | PO BOX 3317
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City | GREENVILLE
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State | NC
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Zip | 27836-1317
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Country | US
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Telephone | 252-752-8880
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Fax | 252-317-2092
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2025-01633
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 4301112414
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 2025-01633
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301112414
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License Number State | MI
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