DR. SHYAM KOMANDUR (NPI# 1184616583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184616583 |
| Entity Type | Individual |
| Full Name | DR. SHYAM KOMANDUR |
| Credential | MD |
| Practice Address |
101 Robeson St Suite 300 Fayetteville NC 28301-5552 |
| Mailing Address |
Po Box 41209 Fayetteville NC 28309-1209 |
| Practice Telephone | 9106091616 |
| Practice Fax Number | 9106091619 |
| Mailing Telephone | 9106096448 |
| Mailing Fax Number | 9106097040 |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 96-00975 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8950040 | 05 |
| Street Address |
101 ROBESON ST SUITE 300 |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28301-5552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285637397 | Leon E Dantzler | Internal Medicine | 101 Robeson St, Suite 300, Fayetteville, NC 28301-5552 | 2005-05-23 |
| 1962014803 | Paige Greene | Pharmacist | 101 Robeson St, Fayetteville, NC 28301-5552 | 2020-08-21 |
| 1013536234 | Ashley Stone | Health Educator | 101 Robeson St, Fayetteville, NC 28301-5552 | 2020-04-09 |
| 1508242280 | Kelly Fynboe | Pharmacist | 101 Robeson St, Suite 107, Fayetteville, NC 28301-5552 | 2015-08-05 |
| 1720412968 | Autumn Lee Mittleider | Pharmacist | 101 Robeson St, Ste 202, Fayetteville, NC 28301-5552 | 2013-08-23 |
| 1447695994 | Erik Wiglama | Internal Medicine | 101 Robeson St, Suite 300, Fayetteville, NC 28301-5552 | 2013-05-09 |
| 1588952329 | John Pasztor | Dietitian, Registered | 101 Robeson St, Suite 410, Fayetteville, NC 28301-5552 | 2011-07-14 |
| 1497045496 | Nduche Chika Onyeaso | Internal Medicine | 101 Robeson St, Suite 405, Fayetteville, NC 28301-5552 | 2011-04-11 |
| 1982900247 | Samantha Moore Paquette | Pharmacist | 101 Robeson St, Suite 107, Fayetteville, NC 28301-5552 | 2011-02-03 |
| 1386970572 | Jamie Dickerhoff | Nurse Practitioner | 101 Robeson St, Suite 410, Fayetteville, NC 28301-5552 | 2009-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134726219 | Jenna Michelle Odneal | Behavior Technician | 16915 Liverpool Pkwy. Suite B., Cornelius, NC 28301 | 2020-10-02 |
| 1790390094 | Jessica Shellman | Counselor | 408 Person St. Ste 103, Fayetteville, NC 28301 | 2020-09-14 |
| 1487205951 | Martha K Richardson | Technician | 720 Teachers Dr, Fayetteville, NC 28301 | 2019-09-25 |
| 1013568161 | Angela Rena Locklear | Counselor | 211 Lamon St, Fayeteville, NC 28301 | 2019-09-20 |
| 1619535747 | Teresa Wilson | Contractor | 1417 Canyionland Ct, Apt 209, Fayetteville, NC 28301 | 2019-06-04 |
| 1912461815 | Catherine Stevenson Nwogalanya | Community Health Worker | 1103 Hillsboro St., Fayetteville, NC 28301 | 2019-01-24 |
| 1811443187 | Michael Carroll | Counselor | 308 Peterson Place, Fayetteville, NC 28301 | 2016-08-28 |
| 1023499886 | Latifa Fedai | Nurse Practitioner | 380 Person Street, Fayettevill, NC 28301 | 2015-06-17 |
| 1265868939 | Aci Support Specialists | Community/Behavioral Health | 1725 Venna Drive, Fayetteville, NC 28301 | 2013-09-25 |
| 1871929547 | Aci Support Specialists | Day Training, Developmentally Disabled Services | 2820 Copenhagen Drive, Fayetteville, NC 28301 | 2013-09-25 |
| Find all providers in zip 28301 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1962876128 | Melissa Jadick | Pediatrics | 135 Trotters Rdg, Fayetteville, GA 30215-6540 | 2015-11-25 |
| 1568807741 | Tequilla L Pryor | Pediatrics | 101 Yorktown Dr Ste 201, Fayetteville, GA 30214-1501 | 2013-05-01 |
| 1891065504 | Camp Creek Pediatrics | Pediatrics | 495 Virginia Highlands, Fayetteville, GA 30215-8233 | 2012-01-11 |
| 1144508698 | Sunshine Pediatrics | Pediatrics | 514 Owen Drive, Fayetteville, NC 28304 | 2011-08-02 |
| 1922339142 | Lynn Covey Morrison | Pediatrics | 460 N Canvas Rd, Fayetteville, AR 72701-4737 | 2010-01-28 |
| 1861627226 | Kidzcare Pediatrics, PC | Pediatrics | 5617 Ramsey Street, Fayetteville, NC 28311-1423 | 2009-05-28 |
| 1053553495 | Neil A Tracy | Pediatrics | 3215 N. North Hill Road, Fayetteville, AR 72703-4424 | 2009-03-31 |
| 1932353208 | Children's Health of Carolina Dba Cumberland Children's Clinic | Pediatrics | 1738 Owen Dr Ste 107, Fayetteville, NC 28304-3419 | 2008-11-12 |
| 1588814628 | Zakiya S Karim | Pediatrics | 1327 Robeson Street, Fayetteville, NC 28305 | 2008-09-25 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28301 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.