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Individual

DR. AJAI SRINIVASAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1330 BOILING SPRINGS RD, NORTH GROVE MEDICAL PARK SUITE 2300, SPARTANBURG, SC 29303-2244
(864) 585-6491
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
19711
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
197110
SC
01
197525
MEDCOST
SC
05
5911182
NC
01
7169404
AETNA
SC
01
G699293365
MEDICARE PIN
SC
01
G699297628
MEDICARE PIN
SC
Enumeration date
02/23/2006
Last updated
03/22/2021
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