Individual
SASIDHARAN TARAVATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3391 HENDERSON DR, JACKSONVILLE, NC 28546-5231
(910) 333-0026
(910) 333-0034
Mailing address
PO BOX 986513, DEPT 100, BOSTON, MA 02298-6513
(910) 333-0026
(910) 333-0034
Taxonomy
Speciality
Code
Description
License number
State
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
999999
NC
2084N0400X
Neurology Physician
2014-00196
NC
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
2014-00196
NC
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
2014-00196
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0090530000
—
WV
Enumeration date
04/05/2006
Last updated
03/10/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us