Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD461973 | PA |
N | 207XS0117X | Orthopaedic Spine Surgeon | A171688 | CA |
NPI | 1043621824 |
---|---|
Provider Name | Kartik Shenoy |
First Address | Nellis Afb, NV 89191-6600 |
Second Address | Nellis Afb, NV 89191-6600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2014 |
Last Update Date | 14/12/2021 |