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Individual

DR. OMAR SURESH PUNJABI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6035 FAIRVIEW RD, CHARLOTTE, NC 28210-3256
(704) 295-3000
Mailing address
6035 FAIRVIEW RD, CHARLOTTE, NC 28210-3256
(704) 295-3000

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
125054371
IL
207W00000X
Ophthalmology Physician
Primary
2013-00729
NC
207WX0107X
Retina Specialist (Ophthalmology) Physician
2013-00729
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1413612
WELLPATH/COVENTRY
NC
01
178GY
BCBSNC
NC
01
609329
WELLCARE OF SC
SC
01
7342147
CIGNA
01
9522709
AETNA
NC
05
NC1835
SC
01
P01266138
MEDICARE - RAILROAD
NC
Enumeration date
08/01/2008
Last updated
04/26/2021
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