Individual
DR. NIKHIL BANSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
122 BEN CASEY DR STE 101, FORT MILL, SC 29708-6594
(803) 396-3937
(803) 396-3945
Mailing address
122 BEN CASEY DR STE 101, FORT MILL, SC 29708-6594
(803) 396-3937
(803) 396-3945
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1151
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1151
LICENSE
SC
05
—
89063M9
—
NC
05
—
D11510
—
SC
Enumeration date
04/10/2006
Last updated
08/11/2021
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