Individual
AMRUTA SURENDRA JAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14135 BALLANTYNE CORPORATE PL STE 225, CHARLOTTE, NC 28277-3871
(704) 316-2930
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-2930
(704) 316-2938
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35.143402
OH
207R00000X
Internal Medicine Physician
I DO NOT HAVE
ZZ
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
2022-00750
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036136462
LICENSE
IL
Enumeration date
12/10/2012
Last updated
11/12/2025
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