Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | ME0060506 | FL |
NPI | 1053345306 |
---|---|
Provider Name | Ashok Kumar Kumar Dhaduvai |
First Address | Ellenton, FL 34222-2007 |
Second Address | Ellenton, FL 34222-2007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 19/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
057742100 | (05) | FL |
57742100 | (05) | FL |
D39084 | (02) | FL |