Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 35.072346 | OH |
NPI | 1093824922 |
---|---|
Provider Name | Mukund Govind Dole |
First Address | Dayton, OH 45404-1815 |
Second Address | Dayton, OH 45404-1815 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 20/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2020593 | (05) | OH |