Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | 37881 | AL |
NPI | 1114282647 |
---|---|
Provider Name | Ashish Mahajan |
First Address | Kettering, OH 45429 |
Second Address | Kettering, OH 45429-1221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2012 |
Last Update Date | 25/03/2019 |