Individual
CHANDRA SHAKARA SHASTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
660 SUMMIT CROSSING PL, GASTONIA, NC 28054-2104
(704) 867-0735
(704) 867-0738
Mailing address
660 SUMMIT CROSSING PL, GASTONIA, NC 28054-2104
(704) 867-0735
(704) 867-0738
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24736
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8975510
—
NC
Enumeration date
03/17/2006
Last updated
02/19/2014
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