MEDICARE: SHAN M. PRADHAN 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	207RH0003X	Hematology & Oncology Physician	2007-00792	NC

General Provider Information

NPI Number	:	1154535565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAN M. PRADHAN MD

Provider Business Mailing Address
First Line	:	UNC CHAPEL HILL HEM ONC
Second Line	:	CB#7305, POB 3RD FLOOR, 170 MANNING DRIVE
City	:	CHAPEL HILL
State	:	NC
Zip	:	27599-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	UNC CHAPEL HILL DIVISION OF HEMATOLOGY ONCOLOGY
Second Line	:	CB# 7305, 3009 OLD CLINIC BLDG.
City	:	CHAPEL HILL
State	:	NC
Zip	:	27599-7305
Country	:	US
Telephone Number	:	919-966-1996
Fax Number	:

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

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	01/29/2009

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