Provider Demographics
NPI:1386006914
Name:DALAL, JUGAL MAYANK (MD)
Entity type:Individual
Prefix:DR
First Name:JUGAL
Middle Name:MAYANK
Last Name:DALAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2325 W ARBORS DR STE 102
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-2664
Mailing Address - Country:US
Mailing Address - Phone:980-224-2008
Mailing Address - Fax:980-426-0005
Practice Address - Street 1:2325 W ARBORS DR STE 102
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-2664
Practice Address - Country:US
Practice Address - Phone:980-224-2008
Practice Address - Fax:980-426-0005
Is Sole Proprietor?:No
Enumeration Date:2016-03-23
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC2020-01857207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program