Healthcare Provider Details

I. General information

NPI: 1457311433
Provider Name (Legal Business Name): NITIN GAIKWAD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 02/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 PELHAM RD
GREENVILLE SC
29615-3300
US

IV. Provider business mailing address

800 PELHAM RD
GREENVILLE SC
29615-3300
US

V. Phone/Fax

Practice location:
  • Phone: 864-234-5800
  • Fax: 864-284-0844
Mailing address:
  • Phone: 864-234-5800
  • Fax: 864-284-0844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number17790
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number17790
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: