MEDICARE: SAPNA JUGNU PITHWA DO

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	2007-00256	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

General Provider Information

NPI Number	:	1134285943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAPNA JUGNU PITHWA DO

Provider Business Mailing Address
First Line	:	112 WOODLAWN AVE
Second Line	:
City	:	MT HOLLY
State	:	NC
Zip	:	28120-1775
Country	:	US
Telephone Number	:	704-827-3575
Fax Number	:	704-827-0840

Provider Business Practice Location Address
First Line	:	112 WOODLAWN AVE
Second Line	:
City	:	MT HOLLY
State	:	NC
Zip	:	28120-1775
Country	:	US
Telephone Number	:	704-827-3575
Fax Number	:	704-827-0840

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

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	09/26/2014

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