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General NPI Number Information
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NPI Number | 1477792182
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Entity Type | Individual
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Provider Name | HEATHER JANE KANEDA DO
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Gender | Female
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Dates
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Enumeration Date | 02/19/2009
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Last Update Date | 09/13/2020
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Provider Practice Location Address
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Address Line | 3623 LATROBE DR SUITE 216
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City | CHARLOTTE
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State | NC
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Zip | 28211
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Country | US
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Telephone | 704-332-1291
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Fax | 704-332-5206
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Provider Business Mailing Address
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Address Line | PO BOX 221249
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City | CHARLOTTE
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State | NC
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Zip | 28222-1249
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Country | US
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Telephone | 704-332-1291
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Fax | 704-332-5206
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 0102203808
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 69057
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | H78072
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2015-01742
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License Number State | NC
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Taxonomy #5
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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 | OT012518
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | DO034477
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License Number State | DC
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