Individual
BHASKAR PUSULURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 JEFFERSON ST, WHITEVILLE, NC 28472-3634
(910) 642-1776
(910) 642-9305
Mailing address
PO BOX 602530, 500 JEFFERSON STREET, CHARLOTTE, NC 28260-2530
(910) 642-1776
(910) 642-9305
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2015-01620
NC
208M00000X
Hospitalist Physician
Primary
2015-01620
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114281383
—
NC
05
—
NC2506
—
SC
Enumeration date
07/02/2012
Last updated
05/05/2020
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