Individual
OMAR S. MANEJWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 BILLINGSLEY RD, BEHAVIORAL HEALTH CENTER CMC RANDOLPH, CHARLOTTE, NC 28211-1009
(704) 358-2700
(704) 358-2945
Mailing address
501 BILLINGSLEY ROAD, BEHAVIORAL HEALTH CENTER CMC RANDO, CHARLOTTE, NC 28211-1009
(704) 358-2700
(704) 358-2938
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
98-01368
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2265661C
MEDICARE
NC
05
—
891247
—
NC
Enumeration date
07/05/2006
Last updated
07/08/2007
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