Provider Demographics
NPI:1982983391
Name:ARYAL, MADAN RAJ (MD)
Entity type:Individual
Prefix:
First Name:MADAN
Middle Name:RAJ
Last Name:ARYAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MADAN
Other - Middle Name:
Other - Last Name:ARYAL
Other - Suffix:
Other - Last Name Type:Other 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:
Mailing Address - Fax:
Practice Address - Street 1:170 MEDICAL PARK RD STE 101
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8541
Practice Address - Country:US
Practice Address - Phone:980-302-7070
Practice Address - Fax:980-302-7075
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2023-01793207RH0003X, 207RX0202X
NY293267207R00000X
PAMT199197390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program