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NPI Code Detail

MEDICARE: DR. DHANASHREE MAHESH MD

MEDICARE:  DR. DHANASHREE  MAHESH  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
12084P0804XChild & Adolescent Psychiatry Physician4301047740MI

General Provider Information

NPI Number : 1912081589
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DHANASHREE MAHESH MD
Provider Business Mailing Address
First Line : 6600 MAHESH DR SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49546-7100
Country : US
Telephone Number : 616-971-5770
Fax Number :
Provider Business Practice Location Address
First Line : 1055 MEDICAL PARK DR SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49546-3607
Country : US
Telephone Number : 616-942-9610
Fax Number : 616-954-3110
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2006
Last Update Date : 11/03/2017

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Directions to “ DR. DHANASHREE MAHESH MD” Practice Location

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