Provider Demographics
NPI:1356638456
Name:NADKARNI, DEVAKI C
Entity Type:Individual
Prefix:
First Name:DEVAKI
Middle Name:C
Last Name:NADKARNI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13324 EDGETREE DR
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28134-9142
Mailing Address - Country:US
Mailing Address - Phone:704-752-7633
Mailing Address - Fax:
Practice Address - Street 1:4430 THE PLZ
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-2034
Practice Address - Country:US
Practice Address - Phone:704-566-9975
Practice Address - Fax:704-566-7986
Is Sole Proprietor?:No
Enumeration Date:2011-07-09
Last Update Date:2011-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17266183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0607093Medicaid