Healthcare Provider Details

I. General information

NPI: 1376544734
Provider Name (Legal Business Name): RAHUL KUMAR DHINGRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 08/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 E BROAD ST
ELYRIA OH
44035-6306
US

IV. Provider business mailing address

578 N LEAVITT RD
AMHERST OH
44001-1131
US

V. Phone/Fax

Practice location:
  • Phone: 440-366-2239
  • Fax: 440-365-1366
Mailing address:
  • Phone: 440-988-1009
  • Fax: 440-988-1227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35054047
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: