Individual
SANJAY KUMAR GANDHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
96 00541
NC
207RI0011X
Interventional Cardiology Physician
Primary
96 00541
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12093
BCBS
—
05
—
1802762000
—
WV
01
—
30231
PARTNERS
—
05
—
5838568
—
VA
01
—
7459721
AETNA
—
01
—
88628
MEDCOST
—
05
—
8912093
—
NC
05
—
Q0054D
—
SC
Enumeration date
12/13/2005
Last updated
06/15/2015
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