Individual
AYSEL ATLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8300 HEALTH PARK STE 109, RALEIGH, NC 27615
(612) 999-7759
Mailing address
8300 HEALTH PARK STE 109, RALEIGH, NC 27615-4731
(919) 322-2064
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
2010-01166
NC
208VP0000X
Pain Medicine Physician
2010-01166
NC
208VP0014X
Interventional Pain Medicine Physician
Primary
2010-01166
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912084617
—
NC
01
—
NN1377A
MEDICARE ID
NC
Enumeration date
11/01/2006
Last updated
01/15/2022
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