Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 2007-01338 | NC |
NPI | 1003009838 |
---|---|
Provider Name | Dr. Shruti Vijaya Simha |
First Address | Greensboro, NC 27401-1230 |
Second Address | Greensboro, NC 27401-1230 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2007 |
Last Update Date | 19/08/2021 |