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Individual

DR. AJAI SHREEVATSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 AIRPORT RD, KINSTON, NC 28501-1604
(252) 522-7000
Mailing address
124 CHARLESTOWNE CIR, WINSTON SALEM, NC 27103-5716
(440) 465-8290

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2014-01417
NC
207R00000X
Internal Medicine Physician
Primary
89029
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000218191
UNISON
OH
01
000000506289
ANTHEM
OH
05
1760549240
MI
05
2720621
OH
01
415034
WELLCARE
OH
01
745494
BUCKEYE
OH
01
7937887
AETNA
01
P00385142
RAILROAD MEDICARE
OH
Enumeration date
01/03/2007
Last updated
01/09/2026
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