MEDICARE: SANJEEV GULATI 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	207R00000X	Internal Medicine Physician	200200698	NC
2	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	ME180483	FL
3	208M00000X	Hospitalist Physician	ME180483	FL
4	207RC0000X	Cardiovascular Disease Physician	200200698	NC
5	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	200200698	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	:	1578574638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANJEEV GULATI MD

Provider Business Mailing Address
First Line	:	PO BOX 19305
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28219-9305
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10650 PARK RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-8538
Country	:	US
Telephone Number	:	704-667-3840
Fax Number	:

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

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	06/01/2026

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Directions to “ SANJEEV GULATI MD” Practice Location

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