Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 2017-00882 | NC |
NPI | 1003236787 |
---|---|
Provider Name | Romin Bonakdar |
First Address | Durham, NC 27704-2147 |
Second Address | Durham, NC 27704-2147 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2014 |
Last Update Date | 14/05/2020 |