Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 17889 | SC |
N | 207RI0011X | Interventional Cardiology | 17889 | SC |
NPI | 1023065828 |
---|---|
Provider Name | Nalin K Srivastava |
First Address | Spartanburg, SC 29303-2248 |
Second Address | Spartanburg, SC 29303-2248 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 27/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
178890 | (05) | SC |
4475988 | AETNA PIN (01) | |
60139 | MEDCOST PIN (01) | |
790517W | (05) | NC |
F15003 | (02) |