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NPI Code Detail

MEDICARE: DR. SENTHILKUMAR GANDHIDASAN MD

MEDICARE: DR. SENTHILKUMAR GANDHIDASAN MD
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
12085R0001XRadiation Oncology Physician57.027336OH

General Provider Information

NPI Number : 1649723891
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SENTHILKUMAR GANDHIDASAN MD
Provider Business Mailing Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-444-2200
Fax Number : 216-636-5105
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-444-2200
Fax Number : 216-636-5105
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2016
Last Update Date : 07/24/2016

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