Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 2018-02485 | NC |
NPI | 1053755074 |
---|---|
Provider Name | Swaroop Sadashiv Gonchikar |
First Address | Charlotte, NC 28209-2290 |
Second Address | Charlotte, NC 28207-1215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2013 |
Last Update Date | 04/12/2018 |