Healthcare Provider Details

I. General information

NPI: 1982608469
Provider Name (Legal Business Name): MUKESH M GANDHI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SQUIRES PT STE A
DUNCAN SC
29334-8867
US

IV. Provider business mailing address

300 E MCBEE AVE STE 300
GREENVILLE SC
29601-2899
US

V. Phone/Fax

Practice location:
  • Phone: 864-968-5126
  • Fax: 864-968-5128
Mailing address:
  • Phone: 864-522-8603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number14842
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: