Provider Demographics
NPI:1043476922
Name:MAHASETH, HARISHCHANDRA (MD)
Entity Type:Individual
Prefix:
First Name:HARISHCHANDRA
Middle Name:
Last Name:MAHASETH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1259 MAGNOLIA ROW TRL
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-2901
Mailing Address - Country:US
Mailing Address - Phone:919-467-2253
Mailing Address - Fax:
Practice Address - Street 1:105 KILMAYNE DR STE A
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4433
Practice Address - Country:US
Practice Address - Phone:919-467-2253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY931855244207RA0000X, 208M00000X
NC2011-00450208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist