Provider Demographics
NPI:1548302177
Name:AJAY K AJMANI MD PA
Entity type:Organization
Organization Name:AJAY K AJMANI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:AJMANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-774-5911
Mailing Address - Street 1:PO BOX 2058
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27331-2058
Mailing Address - Country:US
Mailing Address - Phone:919-774-5911
Mailing Address - Fax:919-774-5957
Practice Address - Street 1:111 DENNIS DR
Practice Address - Street 2:SUITE 121
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-6343
Practice Address - Country:US
Practice Address - Phone:919-774-5911
Practice Address - Fax:919-774-5957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890205QMedicaid
NC2177890AMedicare PIN