Healthcare Provider Details

I. General information

NPI: 1669799276
Provider Name (Legal Business Name): NILESH DIGVIJAY KASHIKAR MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 05/13/2020
Certification Date: 05/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 GREEN VALLEY RD STE 104
GREENSBORO NC
27408-7043
US

IV. Provider business mailing address

11025 RCA CENTER DR STE 300
PALM BEACH GARDENS FL
33410-4269
US

V. Phone/Fax

Practice location:
  • Phone: 336-387-2500
  • Fax: 336-387-2501
Mailing address:
  • Phone: 336-387-2566
  • Fax: 844-751-9263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number2018-02835
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: