MEDICARE: DR. AMIR GASSEMI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	2084P0800X	Psychiatry Physician	2025-01303	NC

General Provider Information

NPI Number	:	1215566294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMIR GASSEMI MD

Provider Business Mailing Address
First Line	:	711 EXECUTIVE PL FL 3
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28305-5193
Country	:	US
Telephone Number	:	910-615-3333
Fax Number	:	910-615-3750

Provider Business Practice Location Address
First Line	:	711 EXECUTIVE PL FL 3
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28305-5193
Country	:	US
Telephone Number	:	910-615-3333
Fax Number	:	910-615-3750

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2020
Last Update Date	:	02/04/2026

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