Provider Demographics
NPI:1487614772
Name:NARASIMHAN, KANAKASABAI LAKSHMI (MD)
Entity type:Individual
Prefix:
First Name:KANAKASABAI
Middle Name:LAKSHMI
Last Name:NARASIMHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KANAKASABAI
Other - Middle Name:LAKSHMI
Other - Last Name:NARASIMHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-316-2930
Mailing Address - Fax:704-316-2938
Practice Address - Street 1:15825 BALLANTYNE MEDICAL PL STE 220
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-4790
Practice Address - Country:US
Practice Address - Phone:704-316-2930
Practice Address - Fax:704-316-2938
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200100919174400000X, 207R00000X, 207RE0101X
SC30162174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89129Y7Medicaid
SC301621Medicaid
NC2292209AMedicare ID - Type Unspecified
SC301621Medicaid
NC89129Y7Medicaid