Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 38398 | OK |
NPI | 1417435611 |
---|---|
Provider Name | Abhijit Gundale |
First Address | Apex, NC 27523-8500 |
Second Address | Apex, NC 27523-8500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2018 |
Last Update Date | 15/09/2021 |