Healthcare Provider Details

I. General information

NPI: 1003510710
Provider Name (Legal Business Name): SAHAJA MAHATHI CARPENTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER BVLD
WINSTON SALEM NC
27157-0001
US

IV. Provider business mailing address

4229 WEDGE DR
PFAFFTOWN NC
27040-9820
US

V. Phone/Fax

Practice location:
  • Phone: 501-380-2280
  • Fax:
Mailing address:
  • Phone: 703-485-5119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: