Provider Demographics
NPI:1871896381
Name:KANJIA, CHETAN (RPH)
Entity type:Individual
Prefix:
First Name:CHETAN
Middle Name:
Last Name:KANJIA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-3468
Mailing Address - Country:US
Mailing Address - Phone:919-212-2045
Mailing Address - Fax:919-231-4340
Practice Address - Street 1:1610 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-3468
Practice Address - Country:US
Practice Address - Phone:919-212-2045
Practice Address - Fax:919-231-4340
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist