Healthcare Provider Details

I. General information

NPI: 1164742938
Provider Name (Legal Business Name): AKHIL SADANAND HEGDE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 BARRETT DR STE 200
RALEIGH NC
27609-7213
US

IV. Provider business mailing address

3700 BARRETT DR STE 200
RALEIGH NC
27609-7213
US

V. Phone/Fax

Practice location:
  • Phone: 919-231-3966
  • Fax:
Mailing address:
  • Phone: 919-231-3966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number201301521
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: