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General NPI Number Information
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NPI Number | 1164781936
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Entity Type | Individual
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Provider Name | PARDEEP KHATRI MD
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Gender | Male
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Dates
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Enumeration Date | 05/14/2012
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 4515 PREMIER DR STE 201
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City | HIGH POINT
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State | NC
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Zip | 27265-8356
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Country | US
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Telephone | 336-716-2255
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Fax |
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Provider Business Mailing Address
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Address Line | 1121 N CHURCH ST
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City | GREENSBORO
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State | NC
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Zip | 27401-1007
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Country | US
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Telephone | 336-832-4380
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101257565
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 2018-00016
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2018-00016
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License Number State | NC
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