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General NPI Number Information
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NPI Number | 1710437470
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Entity Type | Individual
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Provider Name | FNU SHAKUNTULLA MD
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Gender | Female
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Dates
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Enumeration Date | 10/06/2016
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 10880 DURANT RD STE 200
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City | RALEIGH
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State | NC
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Zip | 27614-6629
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Country | US
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Telephone | 919-846-0800
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Fax | 919-846-0880
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Provider Business Mailing Address
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Address Line | PO BOX 603725
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City | CHARLOTTE
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State | NC
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Zip | 28260-3725
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Country | US
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Telephone | 828-575-2625
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Fax | 828-350-2174
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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 | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 2025-02484
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License Number State | NC
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