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NPI Code Detail

MEDICARE: DR. SHILPA MANGALORE PAI REGAN PH.D.

MEDICARE:  DR. SHILPA MANGALORE PAI REGAN  PH.D.
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
1103TC0700XClinical Psychologist102625NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1046UIOTHERNCPROVIDER NUMBER

General Provider Information

NPI Number : 1932300167
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHILPA MANGALORE PAI REGAN PH.D.
Provider Business Mailing Address
First Line : 5540 CENTERVIEW DR
Second Line : SUITE 200
City : RALEIGH
State : NC
Zip : 27606-3363
Country : US
Telephone Number : 919-424-3827
Fax Number :
Provider Business Practice Location Address
First Line : 5540 CENTERVIEW DR
Second Line : SUITE 200
City : RALEIGH
State : NC
Zip : 27606-3363
Country : US
Telephone Number : 919-424-3827
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2007
Last Update Date : 12/12/2007

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Directions to “ DR. SHILPA MANGALORE PAI REGAN PH.D.” Practice Location

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