Doctor Name: | DR. SANJIT R KONDA |
NPI Number: | 1699970442 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 1000 Blythe Blvd Level 1, B Wing, Room 1201 Charlotte, NC - 282035812 |
Business Phone Number: | 7044467608 |
Business Fax Number: | |
Mailing Address: | 4977 Cameron Valley Pkwy, CHARLOTTE |
State: | NC |
Postal Code: | 282103350 |
Phone Number: | 2035896878 |
Fax Number: | |
NPI Enumeration Date: | 06/20/2007 |
NPI Last Update Date: | 11/09/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |