Provider Demographics
NPI:1063413508
Name:NAIDU, ASWANI SUBBARAM (MD)
Entity type:Individual
Prefix:DR
First Name:ASWANI
Middle Name:SUBBARAM
Last Name:NAIDU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:981-215-4960
Mailing Address - Fax:
Practice Address - Street 1:224 FAYETTEVILLE ST STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27601-1374
Practice Address - Country:US
Practice Address - Phone:984-215-4960
Practice Address - Fax:984-215-4965
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200100435207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8912927Medicaid
7773292OtherAETNA
NC8912927Medicaid
NC12927OtherBLUE CROSS&BLUE SHIELD
295383OtherMAMSI
801944OtherPARTNERS MEDICARE CHOICE
NC8912927Medicaid
801944OtherPARTNERS MEDICARE CHOICE