Provider Demographics
NPI:1053639880
Name:EMANI, MADHU KUMAR (MD)
Entity type:Individual
Prefix:
First Name:MADHU
Middle Name:KUMAR
Last Name:EMANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:980-302-7100
Mailing Address - Fax:980-302-7105
Practice Address - Street 1:10030 GILEAD RD STE 350
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-7545
Practice Address - Country:US
Practice Address - Phone:980-302-7100
Practice Address - Fax:980-302-7105
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2025-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN14651207R00000X
FLME119738207RX0202X
MN61400207RX0202X
NC2025-01879207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015708600Medicaid