Provider Demographics
NPI:1306665880
Name:OZA, KEDAR JAGDISH
Entity type:Individual
Prefix:
First Name:KEDAR
Middle Name:JAGDISH
Last Name:OZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8768
Mailing Address - Country:US
Mailing Address - Phone:336-585-1476
Mailing Address - Fax:
Practice Address - Street 1:1475 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8768
Practice Address - Country:US
Practice Address - Phone:336-585-1476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33453183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist