Provider Demographics
NPI:1174670871
Name:DHRUVA, GAYATRI N (OD)
Entity Type:Individual
Prefix:DR
First Name:GAYATRI
Middle Name:N
Last Name:DHRUVA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 RATTAN BAY CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-8834
Mailing Address - Country:US
Mailing Address - Phone:919-619-2180
Mailing Address - Fax:
Practice Address - Street 1:3214 CHARLES B ROOT WYND
Practice Address - Street 2:STE 120
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-5440
Practice Address - Country:US
Practice Address - Phone:919-881-0900
Practice Address - Fax:919-881-0911
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2040152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist