Provider Demographics
NPI:1356591614
Name:PUNJABI, ASHWINI MHATRE (MD)
Entity type:Individual
Prefix:
First Name:ASHWINI
Middle Name:MHATRE
Last Name:PUNJABI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ASHWINI
Other - Middle Name:
Other - Last Name:MHATRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-1925
Mailing Address - Fax:704-384-1930
Practice Address - Street 1:15825 BALLANTYNE MEDICAL PL STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-4790
Practice Address - Country:US
Practice Address - Phone:704-384-1925
Practice Address - Fax:704-384-3147
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-00193207RR0500X
OH35.099191207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology