Provider Demographics
NPI:1558447557
Name:SAXENA, GANESH KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:GANESH
Middle Name:KUMAR
Last Name:SAXENA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:MEDICAL CLINIC, MURDOCH CENTER
Mailing Address - Street 2:1600, EAST C ST
Mailing Address - City:BUTNER
Mailing Address - State:NC
Mailing Address - Zip Code:27509-3000
Mailing Address - Country:US
Mailing Address - Phone:919-575-1940
Mailing Address - Fax:919-575-1648
Practice Address - Street 1:MEDICAL CLINIC, MURDOCH CENTER
Practice Address - Street 2:1600, EAST C ST
Practice Address - City:BUTNER
Practice Address - State:NC
Practice Address - Zip Code:27509-3000
Practice Address - Country:US
Practice Address - Phone:919-575-1940
Practice Address - Fax:919-575-1648
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC21816207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCF54275Medicare UPIN