Healthcare Provider Details

I. General information

NPI: 1861536260
Provider Name (Legal Business Name): GOVERDHAN LAL OHRI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2007
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 COHANNET ST UNIT 1
TAUNTON MA
02780-3908
US

IV. Provider business mailing address

141 WINTHROP ST
TAUNTON MA
02780-4530
US

V. Phone/Fax

Practice location:
  • Phone: 508-824-8743
  • Fax: 508-822-9306
Mailing address:
  • Phone: 508-824-8743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number53053
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: