Individual
DR. KATHY GARLAND MOHANTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6324 FAIRVIEW RD STE 350, CHARLOTTE, NC 28210-0095
(704) 384-8600
(704) 384-8610
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
(704) 384-7830
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
200100746
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
129NC
BCBS PROVIDER #
NC
05
—
89129NC
—
NC
05
—
N0074C
—
SC
Enumeration date
07/18/2006
Last updated
11/11/2021
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