Provider Demographics
NPI:1043390305
Name:GULATI, AJAY S (MD)
Entity Type:Individual
Prefix:
First Name:AJAY
Middle Name:S
Last Name:GULATI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:130 MASON FARM RD
Mailing Address - Street 2:CAMPUS BOX 7229
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-6134
Mailing Address - Country:US
Mailing Address - Phone:919-966-1343
Mailing Address - Fax:919-966-8641
Practice Address - Street 1:130 MASON FARM RD
Practice Address - Street 2:CAMPUS BOX 7229
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-6134
Practice Address - Country:US
Practice Address - Phone:919-966-1343
Practice Address - Fax:919-966-8641
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2008-09-08
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Provider Licenses
StateLicense IDTaxonomies
NC2007-014032080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5904108Medicaid
NC2072667Medicare PIN