Healthcare Provider Details

I. General information

NPI: 1689741803
Provider Name (Legal Business Name): ABHIJIT V KSHIRSAGAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MANNING DR
CHAPEL HILL NC
27599-0001
US

IV. Provider business mailing address

143 W FRANKLIN ST
CHAPEL HILL NC
27516-2539
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-4131
  • Fax:
Mailing address:
  • Phone: 919-966-4131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number009600340
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: