Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 35134045 | OH |
NPI | 1053422337 |
---|---|
Provider Name | Nahush A Mokadam |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 17/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0303874 | (05) | OH |