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General NPI Number Information
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NPI Number | 1356658389
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Entity Type | Individual
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Provider Name | ASHVIN AMARA MD
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Gender | Male
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Dates
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Enumeration Date | 09/13/2010
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Last Update Date | 03/09/2015
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Provider Practice Location Address
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Address Line | 6429 BANNINGTON RD STE B
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City | CHARLOTTE
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State | NC
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Zip | 28226-1345
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Country | US
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Telephone | 704-503-9338
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Fax | 704-503-9339
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Provider Business Mailing Address
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Address Line | 6429 BANNINGTON RD SUITE B
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City | CHARLOTTE
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State | NC
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Zip | 28226-1344
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Country | US
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Telephone | 704-503-9338
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Fax | 704-503-9339
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 2011-01487
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 33814
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License Number State | SC
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