1639275381 NPI number — DR. MOHAN N HARWANI M.D.

Table of content: (NPI 1023046620)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639275381 NPI number — DR. MOHAN N HARWANI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARWANI
Provider First Name:
MOHAN
Provider Middle Name:
N
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639275381
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/08/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
104 W NORTHWOOD ST
Provider Second Line Business Mailing Address:
SUITE E
Provider Business Mailing Address City Name:
GREENSBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27401-1326
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-273-3335
Provider Business Mailing Address Fax Number:
336-273-3315

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
104 W NORTHWOOD ST
Provider Second Line Business Practice Location Address:
SUITE E
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27401-1326
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-273-3335
Provider Business Practice Location Address Fax Number:
336-273-3315
Provider Enumeration Date:
09/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  9600940 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7247000-001 . This is a "CIGNA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 18685 . This is a "PARTNERS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 0202J . This is a "BCBS GROUP" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 25-02502 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 38107 . This is a "BCBS INDIVIDUAL" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 890202J , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 242777 . This is a "MAMSI" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 8938107 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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