Provider Demographics
NPI:1861806150
Name:KAUSHIK, SHIVANI BASHIYAN (MD)
Entity type:Individual
Prefix:
First Name:SHIVANI BASHIYAN
Middle Name:
Last Name:KAUSHIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHIVANI
Other - Middle Name:
Other - Last Name:BASHIYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:205 PAGE RD
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8798
Mailing Address - Country:US
Mailing Address - Phone:919-627-3540
Mailing Address - Fax:
Practice Address - Street 1:1816 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-5057
Practice Address - Country:US
Practice Address - Phone:919-708-1555
Practice Address - Fax:919-708-1556
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2025-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP92884207N00000X
NC2022-00607207N00000X
NJ25MA10816500207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology