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General NPI Number Information
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NPI Number | 1609263805
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Entity Type | Individual
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Provider Name | NAVID AZAR NAFISSI MD
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Gender | Male
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Dates
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Enumeration Date | 04/25/2015
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 329 NC HIGHWAY 801 N
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City | BERMUDA RUN
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State | NC
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Zip | 27006-7905
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Country | US
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Telephone | 336-716-6674
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Fax |
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Provider Business Mailing Address
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Address Line | MEDICAL CENTER BLVD
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City | WINSTON SALEM
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State | NC
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Zip | 27157-0001
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Country | US
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Telephone | 336-716-6674
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Fax |
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 2018-02624
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 2018-02624
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2018-02624
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License Number State | NC
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