Provider Demographics
NPI:1457302754
Name:TEJWANI, LOKESH KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:LOKESH
Middle Name:KUMAR
Last Name:TEJWANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LOKESH
Other - Middle Name:
Other - Last Name:TEJWANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MBBS
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-316-3131
Mailing Address - Fax:704-316-3132
Practice Address - Street 1:1401 MATTHEWS TOWNSHIP PKWY STE 110
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5403
Practice Address - Country:US
Practice Address - Phone:704-316-3131
Practice Address - Fax:704-316-3132
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001010882207RC0000X
NC2008-00136207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO060065493OtherRAILROAD MEDICARE
MO205430200Medicaid
MOP00419300OtherRAILROAD MEDICARE
MO205430200Medicaid
MO969495236Medicare PIN
MOP00419300OtherRAILROAD MEDICARE