Healthcare Provider Details

I. General information

NPI: 1053060863
Provider Name (Legal Business Name): SAHIL DAYAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2022
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 BLYTHE BLVD
CHARLOTTE NC
28203-5812
US

IV. Provider business mailing address

3508 DONEGAL DR
CLEMMONS NC
27012-8678
US

V. Phone/Fax

Practice location:
  • Phone: 170-435-5200
  • Fax:
Mailing address:
  • Phone: 304-293-2436
  • Fax: 304-293-6702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number34928
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2026-01530
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD489561
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: