Healthcare Provider Details

I. General information

NPI: 1982668018
Provider Name (Legal Business Name): KANAKA DURGA ALAHARI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 ATTAIN ST STE 181
FUQUAY VARINA NC
27526-1983
US

IV. Provider business mailing address

912 LILY CLAIRE LN
FUQUAY VARINA NC
27526-2719
US

V. Phone/Fax

Practice location:
  • Phone: 919-557-5433
  • Fax:
Mailing address:
  • Phone: 919-557-5433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD.201072
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number200000696
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number200554162
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: