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NPI Code Detail

MEDICARE: SHIVANGI GANESHAN MBBS

MEDICARE: SHIVANGI GANESHAN MBBS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1457047292
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIVANGI GANESHAN MBBS
Provider Business Mailing Address
First Line : 3800 RESERVOID RD NW
Second Line : GROUND FLOOR, ROOM GG011C
City : WASHINGTON
State : DC
Zip : 20007
Country : US
Telephone Number :
Fax Number : 202-444-1359
Provider Business Practice Location Address
First Line : 1919 E THOMAS RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-7710
Country : US
Telephone Number : 602-933-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2023
Last Update Date : 05/08/2026

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