Provider Demographics
NPI:1518058577
Name:OGLE, ADRIAN MAHENDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:MAHENDRA
Last Name:OGLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:120 CHARLES ROLLINS ROAD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536
Mailing Address - Country:US
Mailing Address - Phone:252-438-2773
Mailing Address - Fax:252-436-1395
Practice Address - Street 1:120 CHARLES ROLLINS RD STE 105
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-2882
Practice Address - Country:US
Practice Address - Phone:252-438-2773
Practice Address - Fax:252-436-1395
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200000920208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89127AXMedicaid
G36513Medicare UPIN
2280986AMedicare PIN
2280986BMedicare PIN