Healthcare Provider Details

I. General information

NPI: 1336727593
Provider Name (Legal Business Name): VARSHA KULKARNI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 07/03/2024
Certification Date: 07/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6030 W HIGHWAY 74 STE F
INDIAN TRAIL NC
28079-3469
US

IV. Provider business mailing address

6030 W HIGHWAY 74 STE F
INDIAN TRAIL NC
28079-3469
US

V. Phone/Fax

Practice location:
  • Phone: 980-993-7400
  • Fax:
Mailing address:
  • Phone: 980-993-7400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL.5538R
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD.48180
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: