MEDICARE: NORTH RALEIGH GASTROENTEROLOGY, P.A.

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	207RG0100X	Gastroenterology Physician	9400030	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245204700
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH RALEIGH GASTROENTEROLOGY, P.A.

Provider Business Mailing Address
First Line	:	PO BOX 98629
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27624-8629
Country	:	US
Telephone Number	:	919-846-9011
Fax Number	:	844-587-9567

Provider Business Practice Location Address
First Line	:	7560 CARPENTER FIRE STATION RD STE 303A
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27519-9637
Country	:	US
Telephone Number	:	919-846-9011
Fax Number	:	844-587-9567

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RAJAT CHANDER
Credential	:	MD
Telephone Number	:	919-846-9011

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	06/21/2021

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