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General NPI Number Information
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NPI Number | 1508754664
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Entity Type | Individual
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Provider Name | HERAN DHIMAL
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Gender | Male
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Dates
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Enumeration Date | 06/26/2025
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 265 BROOKVIEW CENTRE WAY
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City | KNOXVILLE
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State | TN
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Zip | 37919-4049
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Country | US
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Telephone | 561-209-1514
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Fax |
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Provider Business Mailing Address
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Address Line | 6432 WILLOW BROOKE DR
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City | LIBERTY TWP
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State | OH
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Zip | 45011-9062
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Country | US
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Telephone | 817-987-5752
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | 67.000554
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License Number State | OH
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