Individual
SANJANA PRABHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1085 NE GATEWAY CT NE STE 290, CONCORD, NC 28025-2412
(704) 403-4650
Mailing address
PO BOX 602344, CHARLOTTE, NC 28260-2344
(704) 403-4650
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2024-02039
NC
Other
Enumeration date
03/23/2021
Last updated
02/12/2025
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