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General NPI Number Information
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NPI Number | 1679263552
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Entity Type | Organization
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Legal Business Name | KASAJI MEDICAL PC
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Dates
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Enumeration Date | 05/12/2023
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | 5820 E W T HARRIS BLVD STE B
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City | CHARLOTTE
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State | NC
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Zip | 28215-3542
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Country | US
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Telephone | 704-548-7962
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Fax | 704-613-3431
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Provider Business Mailing Address
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Address Line | 5820 E W T HARRIS BLVD STE B
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City | CHARLOTTE
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State | NC
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Zip | 28215-3542
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MOHAMMAD KASAJI
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Credential | MD
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Telephone | 914-589-9963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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