Vishakantaiah, Nagaraja
Vishakantaiah, Nagaraja is an individual health care provider with primary practice located at 4692 Brownsboro Rd , Winston Salem NC 27106-3410. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Vishakantaiah, Nagaraja can be contacted via phone (336) 251-1114.Contact Information
Primary practice address
4692 Brownsboro Rd
Winston Salem NC 27106-3410
Phone: (336) 251-1114
Fax: (336) 251-1117
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 0101840596 | Virginia |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2018-02625 | North Carolina |
Profile Details
| NPI number | 1376541581 |
|---|---|
| LBN Legal business name | Vishakantaiah, Nagaraja |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2005 |
| Last updated | Nov 28th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376541581 | NPPES |
| Virginia | MEDICAID | 010052360 |
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