Individual
AMIRREZA TABATABAI MOTAMENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3024 NEW BERN AVE, RALEIGH, NC 27610-1247
(919) 350-7331
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0351
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2019-00821
NC
208600000X
Surgery Physician
49337
KY
2086S0102X
Surgical Critical Care Physician
Primary
2019-00821
NC
2086S0102X
Surgical Critical Care Physician
49337
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992091128
—
NC
Enumeration date
06/27/2011
Last updated
11/18/2022
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