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Individual

SANJAY J KHIANI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10370 PARK RD, SUITE 202, CHARLOTTE, NC 28210-8508
(704) 817-2022
(704) 817-2024
Mailing address
10370 PARK RD, SUITE 202, CHARLOTTE, NC 28210-8508
(704) 817-2022
(704) 817-2024

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
2012-00056
NC
207K00000X
Allergy & Immunology Physician
41230
KY
207K00000X
Allergy & Immunology Physician
51918
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000541483
ANTHEM PIN
KY
05
200340800
IN
05
200874570
IN
05
35337600
WI
01
9454082
AETNA PIN
KY
Enumeration date
08/21/2007
Last updated
05/16/2012
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