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General NPI Number Information
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NPI Number | 1912320425
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Entity Type | Individual
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Provider Name | MOHAN DUTT M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/04/2014
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 5308 HARROUN RD STE 180
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City | SYLVANIA
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State | OH
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Zip | 43560-2190
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Country | US
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Telephone | 419-291-7555
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Fax | 419-479-2696
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Provider Business Mailing Address
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Address Line | 100 MADISON AVE
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City | TOLEDO
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State | OH
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Zip | 43604-1516
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Country | US
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Telephone |
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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 | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | 4301114307
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | 35C.001162
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301114307
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License Number State | MI
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