Provider Demographics
NPI:1780323832
Name:GOLETIANI, RUSUDANI (MD)
Entity type:Individual
Prefix:MS
First Name:RUSUDANI
Middle Name:
Last Name:GOLETIANI
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 1:170 MANNING, DRIVE, CB# 7025
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7025
Mailing Address - Country:US
Mailing Address - Phone:919-966-8162
Mailing Address - Fax:919-966-2922
Practice Address - Street 1:101 MANNING DRIVE
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514
Practice Address - Country:US
Practice Address - Phone:919-966-8162
Practice Address - Fax:919-966-2922
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program