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NPI Code Detail

MEDICARE: TAMI L MOHAN PA-C

MEDICARE: TAMI L MOHAN PA-C
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
1363A00000XPhysician Assistant50001155OH

General Provider Information

NPI Number : 1720088966
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMI L MOHAN PA-C
Provider Business Mailing Address
First Line : 945 BETHESDA DR STE 200
Second Line :
City : ZANESVILLE
State : OH
Zip : 43701-1880
Country : US
Telephone Number : 740-454-4788
Fax Number :
Provider Business Practice Location Address
First Line : 2945 MAPLE AVE
Second Line :
City : ZANESVILLE
State : OH
Zip : 43701-1762
Country : US
Telephone Number : 740-454-4712
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 07/24/2012

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Directions to “ TAMI L MOHAN PA-C” Practice Location

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