Individual
DR. GHANSHYAM PRADYUMNA DWIVEDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1778 METROMEDICAL DR, FAYETTEVILLE, NC 28304-3861
(910) 483-4680
(910) 484-2704
Mailing address
1778 METROMEDICAL DR, FAYETTEVILLE, NC 28304-3861
(910) 483-4680
(910) 484-2704
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
33230
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033112602
NPI
NC
05
—
8929604
—
NC
Enumeration date
05/27/2005
Last updated
04/09/2019
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