Individual
AJAY VEERAGANDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 TARPON TRL, JACKSONVILLE, NC 28546-5287
(910) 938-1114
(910) 938-1118
Mailing address
200 TARPON TRL, JACKSONVILLE, NC 28546-5287
(910) 938-1114
(910) 938-1118
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
200301070
NC
2084P0804X
Child & Adolescent Psychiatry Physician
200301070
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5901420
—
NC
Enumeration date
09/16/2006
Last updated
11/12/2012
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