Healthcare Provider Details

I. General information

NPI: 1306862909
Provider Name (Legal Business Name): GAURANG P. MAVANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WYOMING ST SUITE NW3300
DAYTON OH
45409-2722
US

IV. Provider business mailing address

4478 ANDEAN WAY
CARMEL IN
46074-7767
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-8394
  • Fax: 937-208-8338
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number01083586A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.126507
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01083586A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: