Healthcare Provider Details

I. General information

NPI: 1104567130
Provider Name (Legal Business Name): DHRUVKUMAR HARESHKUMAR GADHIYA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3310 DUTCH CREEK DR # 101
CHARLOTTE NC
28215-1667
US

IV. Provider business mailing address

3310 DUTCH CREEK DR # 101
CHARLOTTE NC
28215-1667
US

V. Phone/Fax

Practice location:
  • Phone: 980-334-3837
  • Fax:
Mailing address:
  • Phone: 980-334-3837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2026-04153
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: