Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 35-073554 | OH |
NPI | 1184711186 |
---|---|
Provider Name | Vivek Malhotra |
First Address | Akron, OH 44308-1063 |
Second Address | Akron, OH 44308-1063 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2177291 | (05) | OH |
H49013 | (02) |