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1235129321

NPI Code Detail

MEDICARE: DR. SANJEEV KUMAR DEVESHWAR MD

MEDICARE: DR. SANJEEV KUMAR DEVESHWAR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	200000768	NC
2	2085R0204X	Vascular & Interventional Radiology Physician	200000768	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	300113396	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1269U	OTHER	NC	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	99035	OTHER	NC	MEDCOST
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	36808	OTHER	NC	PARTNERS
7	1608432	OTHER	NC	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1235129321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANJEEV KUMAR DEVESHWAR MD

Provider Business Mailing Address
First Line	:	PO BOX 63112
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28263-3112
Country	:	US
Telephone Number	:	336-274-9617
Fax Number	:	336-482-2177

Provider Business Practice Location Address
First Line	:	1331 NORTH ELM STREET
Second Line	:	SUITE 200
City	:	GREENSBORO
State	:	NC
Zip	:	27401-6304
Country	:	US
Telephone Number	:	336-274-9617
Fax Number	:	336-482-2177

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	03/24/2023

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Directions to “ DR. SANJEEV KUMAR DEVESHWAR MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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