Basic Information
| Provider Information | |||||||||
| NPI: | 1972702470 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NANGIA | ||||||||
| FirstName: | SHARAD | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 13808 PROFESSIONAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | HUNTERSVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280787948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043774009 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 13808 PROFESSIONAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | HUNTERSVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280787948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043774009 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2007 | ||||||||
| LastUpdateDate: | 03/31/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 03/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 856761 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RG0100X | 2022-00149 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | FN5031024 | 01 | NC | FEDERAL DEA | OTHER | C148999 | 01 | CA | STATE MEDICAL LICENSE | OTHER | 2022-00149 | 01 | NC | STATE MEDICAL LICENSE | OTHER | FN5031024 | 01 | CA | FEDERAL DEA LICENSE | OTHER |