Individual
DR. RANJAN SIMON MAITRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
706 SUMMIT CROSSING PL, GASTONIA, NC 28054-2175
(704) 323-2000
Mailing address
4601 PARK RD, STE 300, CHARLOTTE, NC 28209-3239
(704) 323-2000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2000-00882
NC
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
2000-00882
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891279E
—
NC
05
—
N00882
—
SC
Enumeration date
11/17/2005
Last updated
05/12/2010
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