Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 4301071798 | MI |
NPI | 1205864766 |
---|---|
Provider Name | Dr. Paresh Mahajan |
First Address | Tampa, FL 33612-5513 |
Second Address | Tampa, FL 33612-5513 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 13/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
28144300 | (05) | FL |
300F36238 | BCBSM (01) | MI |
4585738 | (05) | MI |
H91638 | (02) | MI |