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General NPI Number Information
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NPI Number | 1750464863
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Entity Type | Organization
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Legal Business Name | SURESH K. MAHAJAN M.D. INC.
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 08/06/2009
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Provider Practice Location Address
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Address Line | 7255 OLD OAK BLVD C101
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City | CLEVELAND
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State | OH
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Zip | 44130-3329
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Country | US
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Telephone | 440-816-2789
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Fax | 440-816-2811
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Provider Business Mailing Address
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Address Line | 7255 OLD OAK BLVD C101
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City | CLEVELAND
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State | OH
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Zip | 44130-3329
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Country | US
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Telephone | 440-816-2789
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Fax | 440-816-2811
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Authorized Official
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Title or Position | OWNER
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Name | SURESH K MAHAJAN
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Credential | M.D.
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Telephone | 440-816-2789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 35-05-8230-M
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License Number State | OH
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