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General NPI Number Information
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NPI Number | 1588896401
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Entity Type | Individual
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Provider Name | DR. SUMMIT BHANJI KUNDARIA
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Gender | Male
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Dates
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Enumeration Date | 08/11/2009
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Last Update Date | 11/17/2016
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Provider Practice Location Address
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Address Line | 309 S SHARON AMITY RD STE 202
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City | CHARLOTTE
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State | NC
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Zip | 28211-2978
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Country | US
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Telephone | 704-593-6802
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Fax |
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Provider Business Mailing Address
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Address Line | 309 S SHARON AMITY RD STE 202
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City | CHARLOTTE
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State | NC
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Zip | 28211-2978
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Country | US
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Telephone | 704-593-6802
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Fax | 980-859-2784
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MT195894
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 2016-01378
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | A135755
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License Number State | CA
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