Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 2018-00451 | NC |
NPI | 1114160652 |
---|---|
Provider Name | Meera Gangam |
First Address | Charlotte, NC 28219-9305 |
Second Address | Concord, NC 28025-2982 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2009 |
Last Update Date | 05/01/2022 |