Individual
DR. SHOUKATH ANSARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
102 ENDO LN, HAMLET, NC 28345-4562
(910) 205-3035
(910) 205-3062
Mailing address
102 ENDO LN, HAMLET, NC 28345-4562
(843) 479-6268
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
10779
SC
207RG0100X
Gastroenterology Physician
Primary
27767
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100008692
RR MEDICARE
SC
01
—
100009710
RR MEDICARE
NC
05
—
107798
—
SC
01
—
11568
NC BC INDIVIDUAL
NC
01
—
2223641
MEDICARE
NC
05
—
8911568
—
NC
01
—
D091992621
MEDICARE
SC
Enumeration date
08/16/2005
Last updated
02/02/2011
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