Healthcare Provider Details

I. General information

NPI: 1407807092
Provider Name (Legal Business Name): THE NEUROLOGICAL INSTITUTE P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2607 E 7TH ST STE 200
CHARLOTTE NC
28204-4308
US

IV. Provider business mailing address

2607 E 7TH ST STE 200
CHARLOTTE NC
28204-4308
US

V. Phone/Fax

Practice location:
  • Phone: 704-449-6064
  • Fax: 704-731-0936
Mailing address:
  • Phone: 704-449-6064
  • Fax: 704-731-0936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. T HEMANTH P RAO
Title or Position: PRESIDENT
Credential: MD
Phone: 704-449-6064