Provider Demographics
NPI:1568403541
Name:WALDO, AIKYA F (MD)
Entity Type:Individual
Prefix:
First Name:AIKYA
Middle Name:F
Last Name:WALDO
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 12845
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-0017
Mailing Address - Country:US
Mailing Address - Phone:704-864-8772
Mailing Address - Fax:704-866-7853
Practice Address - Street 1:500 E LAUCHWOOD DR
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5501
Practice Address - Country:US
Practice Address - Phone:910-291-7781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200001482207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC127YCOtherNC BLUE CROSS
NC2337601OtherMEDICARE OTHER IDENTFIER
NC89127YCMedicaid
NC200943360OtherRAILROAD MEDICARE
NC2345338Medicare PIN
NC2281933CMedicare ID - Type Unspecified
NCH27464Medicare UPIN
NC127YCOtherNC BLUE CROSS