Provider Demographics
NPI:1629116801
Name:VAISHNAVI, SANDEEP (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDEEP
Middle Name:
Last Name:VAISHNAVI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 BLUE RIDGE ROAD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6459
Mailing Address - Country:US
Mailing Address - Phone:919-785-5055
Mailing Address - Fax:
Practice Address - Street 1:1829 EAST FRANKLIN STREET
Practice Address - Street 2:BUILDING 400
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-5865
Practice Address - Country:US
Practice Address - Phone:919-933-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP215372084P0800X
IL0361189112084P0800X
NC2008-019662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry