Provider Demographics
NPI:1932498581
Name:DABHADKAR, KAUSTUBH CHANDRASHEKHAR
Entity Type:Individual
Prefix:DR
First Name:KAUSTUBH
Middle Name:CHANDRASHEKHAR
Last Name:DABHADKAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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:704-316-3024
Mailing Address - Fax:980-302-2110
Practice Address - Street 1:8201 HEALTHCARE LOOP STE 201
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-7072
Practice Address - Country:US
Practice Address - Phone:704-316-3024
Practice Address - Fax:980-302-2110
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-00330207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine