Provider Demographics
NPI:1124114178
Name:PATHAK, AMAN J (MD)
Entity type:Individual
Prefix:DR
First Name:AMAN
Middle Name:J
Last Name:PATHAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2310 DELANEY RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6013
Mailing Address - Country:US
Mailing Address - Phone:910-763-4511
Mailing Address - Fax:910-763-6608
Practice Address - Street 1:2310 DELANEY RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6013
Practice Address - Country:US
Practice Address - Phone:910-763-4511
Practice Address - Fax:910-763-6608
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC143C7OtherBCBS NC PROVIDER #