Healthcare Provider Details

I. General information

NPI: 1831270818
Provider Name (Legal Business Name): GENERAL & VASCULAR SURGICAL SPECIALISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11155 KENWOOD RD SUITE 6C
CINCINNATI OH
45242-1845
US

IV. Provider business mailing address

11155 KENWOOD RD SUITE 6C
CINCINNATI OH
45242-1845
US

V. Phone/Fax

Practice location:
  • Phone: 513-385-1919
  • Fax: 513-385-6208
Mailing address:
  • Phone: 513-385-1919
  • Fax: 513-385-6208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KRIS MAHALINGAM
Title or Position: PRESIDENT
Credential: MD
Phone: 513-385-1919