Individual
ASEEM SRIVASTAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 HEART DR, EAST CAROLINA HEART INSTITUTE AT ECU, GREENVILLE, NC 27834-8944
(252) 744-4400
(252) 744-3987
Mailing address
PO BOX 751069, ECU PHYSICIANS, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2013-02014
NC
2086S0120X
Pediatric Surgery Physician
LT000710
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689952574
—
NC
01
—
182PJ
BCBS NC
NC
Enumeration date
07/27/2011
Last updated
04/15/2014
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