| Gowd Shiva Nagaraj, MD | |
|
2131 S 17th St, Wilmington, NC 28401-7407 | |
| (910) 343-7074 | |
| Not Available |
| Full Name | Gowd Shiva Nagaraj |
|---|---|
| Gender | Male |
| Speciality | Pathology |
| Experience | 62 Years |
| Location | 2131 S 17th St, Wilmington, North Carolina |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275659641 | NPI | - | NPPES |
| 5911282 | Medicaid | NC | |
| 152K9 | Other | NC | BCBS OF NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 2009-00324 (North Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Lucie Medical Center | Port saint lucie, FL | Hospital |
| Lawnwood Regional Medical Center & Heart Institute | Fort pierce, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Integrated Regional Laboratories Pathology Services, Llc | 9133244346 | 134 |
| Entity Name | Ameripath Hospital Services-florida Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124091509 PECOS PAC ID: 8022027572 Enrollment ID: O20060412000199 |
| Mailing Address | Practice Location Address |
|---|---|
| Gowd Shiva Nagaraj, MD Po Box 20169, Roanoke, VA 24018-0506 Ph: () - | Gowd Shiva Nagaraj, MD 2131 S 17th St, Wilmington, NC 28401-7407 Ph: (910) 343-7074 |
Dr. Babatunde Adewale Olatidoye, MD Pathology Medicare: Medicare Enrolled Practice Location: 2131 S 17th St, Wilmington, NC 28401 Phone: 910-362-9511 | |
Dr. Brian Charles Shiro, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 1915 S 17th St, Suite 100, Wilmington, NC 28401 Phone: 910-362-9511 | |
Dr. Stephen P Olsen, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 2131 S 17th St, Wilmington, NC 28401 Phone: 910-343-7074 Fax: 910-343-7829 | |
Rachel Jester, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 2131 S 17th St, Wilmington, NC 28401 Phone: 910-343-7074 Fax: 910-343-7829 | |
Dr. Katharine Liu, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 2131 S 17th St, Wilmington, NC 28401 Phone: 910-362-9511 | |
Dr. Philip Martin Barber, MBBS Pathology Medicare: Accepting Medicare Assignments Practice Location: 2131 S 17th St, Wilmington, NC 28401 Phone: 910-343-7074 Fax: 910-343-7829 |