Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 2016-01599 | NC |
N | 207T00000X | Neurosurgeon | MD050194L | PA |
NPI | 1053319129 |
---|---|
Provider Name | Ashvin T Ragoowansi |
First Address | Gastonia, NC 28054-3453 |
Second Address | Gastonia, NC 28054-3453 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 08/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0014211140001 | (05) | PA |
0014211140004 | (05) | PA |
3810010808 | (05) | WV |
F20637 | (02) | PA |