Provider Demographics
NPI:1639275381
Name:HARWANI, MOHAN N (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAN
Middle Name:N
Last Name:HARWANI
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 1:104 W NORTHWOOD ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1326
Mailing Address - Country:US
Mailing Address - Phone:336-273-3335
Mailing Address - Fax:336-273-3315
Practice Address - Street 1:104 W NORTHWOOD ST
Practice Address - Street 2:SUITE E
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1326
Practice Address - Country:US
Practice Address - Phone:336-273-3335
Practice Address - Fax:336-273-3315
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9600940207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7247000-001OtherCIGNA
NC18685OtherPARTNERS
NC0202JOtherBCBS GROUP
NC25-02502OtherUNITED HEALTHCARE
NC38107OtherBCBS INDIVIDUAL
NC890202JMedicaid
NC242777OtherMAMSI
NC8938107Medicaid
NC242777OtherMAMSI
NC2230159Medicare ID - Type Unspecified