MEDICARE: PINAKIN PUSHKARRAI VIAS M.D.

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	207R00000X	Internal Medicine Physician		NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8506Y	OTHER	NC	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346247756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PINAKIN PUSHKARRAI VIAS M.D.

Provider Business Mailing Address
First Line	:	4384 FAYETTEVILLE RD
Second Line	:
City	:	LUMBERTON
State	:	NC
Zip	:	28358-2677
Country	:	US
Telephone Number	:	910-738-1141
Fax Number	:	910-738-1142

Provider Business Practice Location Address
First Line	:	4384 FAYETTEVILLE RD
Second Line	:
City	:	LUMBERTON
State	:	NC
Zip	:	28358-2677
Country	:	US
Telephone Number	:	910-738-1141
Fax Number	:	910-738-1142

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	07/08/2007

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