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General NPI Number Information
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NPI Number | 1992098776
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Entity Type | Individual
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Provider Name | SYAM BANDI
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Gender | Male
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Dates
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Enumeration Date | 05/26/2011
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Last Update Date | 05/26/2011
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Provider Practice Location Address
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Address Line | 1560 HIGH WAY 56
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City | CREEDMOOR
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State | NC
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Zip | 27522
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Country | US
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Telephone | 919-528-1538
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Fax |
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Provider Business Mailing Address
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Address Line | 204 LIBERTY ROSE DR
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City | MORRISVILLE
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State | NC
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Zip | 27560
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Country | US
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Telephone | 815-342-7535
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 20959
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License Number State | NC
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