Basic Information
| Provider Information | |||||||||
| NPI: | 1396766168 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHANARDI | ||||||||
| FirstName: | GANESH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4726 NW 56TH DR | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326064316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523750287 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3925 NW 43RD ST | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326064565 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523711777 | ||||||||
| FaxNumber: | 3523710298 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME74633 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.