Healthcare Provider Details

I. General information

NPI: 1568488807
Provider Name (Legal Business Name): SANGEETA T. MAHAJAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 01/06/2021
Certification Date: 01/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5850 LANDERBROOK DR STE 210
MAYFIELD HTS OH
44124-4071
US

IV. Provider business mailing address

11100 EUCLID AVE # MAC5034
CLEVELAND OH
44106-1716
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-3941
  • Fax:
Mailing address:
  • Phone: 216-844-4906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35-086378
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number35.086378
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number350856378
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: