MEDICARE: NIPA DANI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	4301078535	MI
2	207Q00000X	Family Medicine Physician	2009-01410	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013997212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIPA DANI MD

Provider Business Mailing Address
First Line	:	PO BOX 60447
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-0447
Country	:	US
Telephone Number	:	704-316-3616
Fax Number	:	704-316-1199

Provider Business Practice Location Address
First Line	:	6488 WEDDINGTON-MONROE RD
Second Line	:
City	:	WESLEY CHAPEL
State	:	NC
Zip	:	28104-7948
Country	:	US
Telephone Number	:	704-316-5650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	10/25/2020

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Directions to “ NIPA DANI MD” Practice Location

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