AMUDHAN JYOTHIDASAN (NPI# 1619282365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619282365 |
| Entity Type | Individual |
| Full Name | AMUDHAN JYOTHIDASAN |
| Credential | M.D. |
| Practice Address |
3634 Cape Center Dr Fayetteville NC 28304-4406 |
| Mailing Address |
3634 Cape Center Drive Fayetteville NC 28304 |
| Practice Telephone | (910) 485-6470 |
| Mailing Telephone | (910) 485-6470 |
| Enumeration Date | 2010-08-18 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 245539 | MA | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
2017-01125 | NC | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 55 Lake Ave N, Worcester, MA 016550002 | 7744422173 |
| Street Address |
3634 CAPE CENTER DR |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-4406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154393080 | Brenda May-depaola | Internal Medicine | 3634 Cape Center Dr, Fayetteville, NC 28304-4406 | 2006-02-03 |
| 1154805448 | Shavegas Robinson Sutton | Nurse Practitioner | 3634 Cape Center Dr, Fayetteville, NC 28304-4406 | 2018-09-21 |
| 1508052457 | Dylan K Miller | Nurse Practitioner | 3634 Cape Center Dr, Fayetteville, NC 28304-4406 | 2007-09-24 |
| 1831165802 | Cape Fear Cardiology Associates Pa | Internal Medicine | 3634 Cape Center Dr, Fayetteville, NC 28304 | 2006-02-28 |
| 1821062522 | Michael Carson Hodges | Internal Medicine | 3634 Cape Center Dr, Fayetteville, NC 28304 | 2006-02-17 |
| 1760456537 | Timothy P Blair | Internal Medicine | 3634 Cape Center Dr, Fayetteville, NC 28304 | 2006-02-16 |
| 1861466658 | Stephen Mabry Ginn | Internal Medicine | 3634 Cape Center Dr, Fayetteville, NC 28304 | 2006-02-16 |
| 1538133301 | Srinivas Munugoti | Internal Medicine | 3634 Cape Center Dr, Fayetteville, NC 28304 | 2006-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174965826 | Valley Cardiology, Pa | Internal Medicine | 6562 Stone Mountain Farm Rd, Fayetteville, NC 28311-1183 | 2013-07-23 |
| 1659560647 | Oduwole Organization Inc | Internal Medicine | 1415 Highway 85 N Ste 310-296, Fayetteville, GA 30214-7738 | 2007-10-16 |
| 1982648663 | Northwest Arkansas Heart & Vascular Center | Internal Medicine | 3211 N. North Hills Blvd., Suite 110, Fayetteville, AR 72703 | 2006-06-15 |
| 1023072808 | David A Churchill | Internal Medicine | 3211 N Northhills Blvd, Suite 110, Fayetteville, AR 72703-4007 | 2006-04-17 |
| 1912984568 | Arun Prahash | Internal Medicine | 1267 Highway 54 W Ste 2200, Fayetteville, GA 30214-2110 | 2005-12-26 |
| 1679890966 | Washington Regional Medical System | Internal Medicine | 3211 N Northhills Blvd, Suite 110, Fayetteville, AR 72703-4007 | 2010-04-26 |
| 1386827574 | Cumberland Cardiology, P.a. | Internal Medicine | 909 S Mcpherson Church Rd, Fayetteville, NC 28303-5350 | 2007-12-11 |
| 1831386556 | Zubair Ahmed | Internal Medicine | 3211 N Northhills Blvd, Suite 110, Fayetteville, AR 72703-4007 | 2007-09-26 |
| 1689769507 | Cardiac Disease Specialists, PC | Internal Medicine | 1267 Highway 54 W, Ste 2200, Fayetteville, GA 30214-4548 | 2006-10-04 |
| 1538254487 | Cardiac Disease Specialists, PC | Internal Medicine | 101 Yorktown Dr, Ste 209, Fayetteville, GA 30214-1568 | 2006-10-04 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
Please comment or provide details below to improve the information on AMUDHAN JYOTHIDASAN.
| 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.