Individual
DR. PAVAN ISANAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2555 COURT DR STE 200, GASTONIA, NC 28054-2178
(703) 587-5715
Mailing address
2555 COURT DR STE 200, GASTONIA, NC 28054-2178
(703) 587-5715
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101267290
VA
207RI0011X
Interventional Cardiology Physician
Primary
2023-01291
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
WY
Other
Enumeration date
03/29/2016
Last updated
05/30/2023
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