Komandur, Shyam
Komandur, Shyam is an individual health care provider with primary practice located at 101 Robeson St Suite 300, Fayetteville NC 28301-5552. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Komandur, Shyam can be contacted via phone (910) 609-1616.Contact Information
Primary practice address
101 Robeson St Suite 300
Fayetteville NC 28301-5552
Phone: (910) 609-1616
Fax: (910) 609-1619
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 96-00975 | North Carolina |
Profile Details
| NPI number | 1184616583 |
|---|---|
| LBN Legal business name | Komandur, Shyam |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 22nd, 2005 |
| Last updated | Jul 9th, 2007 - about 17 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 | 1184616583 | NPPES |
| North Carolina | MEDICAID | 8950040 |
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