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Contact Information

CHANNAIAH S MYSORE
100 E CARROLL ST
SALISBURY, MD21801
 Phone: 800-749-5191
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurology

2084N0400X 13 Physician/Neurology
Indicates primary specialty

NPI Profile & details for CHANNAIAH S MYSORE · (Male)

NPI Number 1881900652
Status Active
Credentials
Entity Individual
Enumeration date 08/31/2010
Last updated 01/06/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • MD License # D77961
Hospital affiliation(s)
  • VIDANT MEDICAL CENTER - (Acute Care)
    2100 STANTONSBURG RD
    GREENVILLE, NC 27834
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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