Gangadhara, Shreyas
Gangadhara, Shreyas is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Gangadhara, Shreyas can be contacted via phone (601) 984-5500.Contact Information
Primary practice address
2500 N State St
Jackson MS 39216-4500
Phone: (601) 984-5500
Fax: (601) 984-5503
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 24364 | Mississippi |
Profile Details
| NPI number | 1992092548 |
|---|---|
| LBN Legal business name | Gangadhara, Shreyas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 4th, 2011 |
| Last updated | Jan 3rd, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992092548 | NPPES |
| Mississippi | MEDICAID | 06101246 | |
| Mississippi | MEDICAID | 06230860 |
Popular Providers
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