Provider Demographics
NPI:1376525816
Name:KASHYAP, SONA SHRIKANT (MD)
Entity Type:Individual
Prefix:
First Name:SONA
Middle Name:SHRIKANT
Last Name:KASHYAP
Suffix:
Gender:F
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:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10650 PARK RD
Practice Address - Street 2:STE 330
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8538
Practice Address - Country:US
Practice Address - Phone:704-468-8877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-01236207R00000X, 207RE0101X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5914375Medicaid
SC1255499950OtherGROUP NPI
SC267838Medicaid
SCAA04437551OtherMEDICARE LEGACY
SC1376525816OtherINDIVIDUAL NPI
NC1376525816Medicaid
NCNCW869AMedicare PIN
SCAA04437551OtherMEDICARE LEGACY
SCI07600Medicare UPIN
NC2075600AMedicare PIN