Basic Information
| Provider Information | |||||||||
| NPI: | 1548422595 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SARAIYA | ||||||||
| FirstName: | NEHALI | ||||||||
| MiddleName: | VIRA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6035 FAIRVIEW RD | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282103256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7042953000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10512 PARK RD | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282108475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7042953650 | ||||||||
| FaxNumber: | 7042953666 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2008 | ||||||||
| LastUpdateDate: | 04/26/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 036.125355 | IL | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 2014-00098 | NC | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | NC2036 | 05 | SC | MEDICAID | 185C7 | 01 | NC | BCBSNC | OTHER | P01512572 | 01 | NC | RAILROAD MEDICARE | OTHER | 967403 | 01 | WELLCARE | OTHER | 2207133 | 01 | WELLPATH | OTHER |