Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35091230 | OH |
Y | 2084N0402X | Child Neurologist | 2011-01373 | NC |
NPI | 1194919514 |
---|---|
Provider Name | Dr. Shalaka D Indulkar |
First Address | Fayetteville, NC 28305-5250 |
Second Address | Fayetteville, NC 28303-5510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2007 |
Last Update Date | 19/02/2019 |