Provider Demographics
NPI:1841298619
Name:NARASIMHAN, LAKSHMI MR (MD)
Entity type:Individual
Prefix:
First Name:LAKSHMI
Middle Name:MR
Last Name:NARASIMHAN
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 1:264 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-6332
Mailing Address - Country:US
Mailing Address - Phone:910-455-7001
Mailing Address - Fax:910-455-9778
Practice Address - Street 1:264 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6332
Practice Address - Country:US
Practice Address - Phone:910-455-7001
Practice Address - Fax:910-455-9778
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9500674174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2210304DOtherMEDICARE
NC8963022Medicaid
NC2210304DOtherMEDICARE