Healthcare Provider Details

I. General information

NPI: 1871036160
Provider Name (Legal Business Name): APARNA YEGGALAM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2016
Last Update Date: 08/19/2022
Certification Date: 08/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16525 HOLLY CREST LN STE 230
HUNTERSVILLE NC
28078-4912
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 704-316-6360
  • Fax: 704-316-6361
Mailing address:
  • Phone: 704-316-6360
  • Fax: 704-316-6361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT212323
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2022-02019
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number2022-02019
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: