Provider Demographics
NPI:1215936398
Name:PASI, DEEPAK (MD)
Entity type:Individual
Prefix:DR
First Name:DEEPAK
Middle Name:
Last Name:PASI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 BLUE RIDGE RD STE 400
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6477
Mailing Address - Country:US
Mailing Address - Phone:919-787-5380
Mailing Address - Fax:919-784-5622
Practice Address - Street 1:4414 LAKE BOONE TRAIL
Practice Address - Street 2:SUITE 402
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-7520
Practice Address - Country:US
Practice Address - Phone:919-784-5600
Practice Address - Fax:919-784-5601
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26967174400000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No174400000XOther Service ProvidersSpecialist
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8965780Medicaid
NCC85907Medicare UPIN
NC8965780Medicaid
NC209431CMedicare PIN
NC209431JMedicare PIN