Healthcare Provider Details

I. General information

NPI: 1194948364
Provider Name (Legal Business Name): MAHESH K JINDAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 05/23/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 TECHNOLOGY AVE
NEW ALBANY IN
47150-8548
US

IV. Provider business mailing address

4101 TECHNOLOGY AVE
NEW ALBANY IN
47150-8548
US

V. Phone/Fax

Practice location:
  • Phone: 812-941-4500
  • Fax:
Mailing address:
  • Phone: 812-941-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number33299
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number01064176A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: