Provider Demographics
NPI:1164641783
Name:DALVI, GAURI RAHUL (MD, PHD)
Entity Type:Individual
Prefix:
First Name:GAURI
Middle Name:RAHUL
Last Name:DALVI
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:GAURI
Other - Middle Name:VIJAY
Other - Last Name:GAIKWAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:400 LIBERTY HILL RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-2446
Mailing Address - Country:US
Mailing Address - Phone:910-739-3318
Mailing Address - Fax:910-671-3600
Practice Address - Street 1:400 LIBERTY HILL RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2446
Practice Address - Country:US
Practice Address - Phone:910-739-3318
Practice Address - Fax:910-671-3600
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAGETP.LSU.G02010.PD208000000X
NC2007-01100208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12673732OtherPHCS MULTIPLAN
NC1107248OtherCOVENTRY NATIONAL - COVENTRY PPO
NC2813371OtherUNITED HEALTHCARE
NC1164641783OtherHUMANA
NC200774OtherMEDCOST LLC
NC9910070OtherAETNA
NC1164641783OtherHEALTHNET FEDERAL SERVICES
NC1164641783Medicaid
NCFH1101590OtherFIRST CAROLINA CARE
NC1164641783OtherDOCTORS DIRECT
NC868004OtherCOVENTRY OF THE CAROLINAS
NC4048561OtherCIGNA GREATWEST
NC5907580Medicaid
NC5907850OtherNC HEALTH CHOICE
NC1479HOtherBLUECROSS BLUESHIELD
NC868004OtherWELLPATH