Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 291125 | NY |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 52519 | SC |
NPI | 1104345594 |
---|---|
Provider Name | Dr. Vandit Sardana |
First Address | Beaufort, SC 29902-5441 |
Second Address | Beaufort, SC 29902-6185 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2017 |
Last Update Date | 05/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
52519 | STATE LICENSE BOARD (01) | SC |
525195 | (05) | SC |