Individual
HARSHA VARDHAN ALLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-5416
(704) 384-5992
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-5416
(704) 384-5992
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2013-02354
NC
207R00000X
Internal Medicine Physician
4301089403
MI
208M00000X
Hospitalist Physician
Primary
2013-02354
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417159518
—
NC
01
—
CI1999
RAILROAD MEDICARE
MI
05
—
NC2407
—
SC
05
—
PENDING
—
MI
Enumeration date
06/01/2007
Last updated
02/01/2023
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