Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301107008 | MI |
N | 208000000X | Pediatrician | 68839-20 | WI |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 35.141502 | OH |
N | 2080N0001X | Neonatal-Perinatal Doctor | 68839-20 | WI |
NPI | 1013390582 |
---|---|
Provider Name | Devashis Mukherjee |
First Address | Cleveland, OH 44106-1716 |
Second Address | Cleveland, OH 44106-1716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2015 |
Last Update Date | 24/06/2021 |