Doctor Name: | MALAY SURESH GANDHI |
NPI Number: | 1487877346 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D |
License Number: | 0101248023 |
Business Practice Address: | 4805 49th St N St Petersburg, FL - 337093859 |
Business Phone Number: | 7275441441 |
Business Fax Number: | 7575458263 |
Mailing Address: | 4805 49th St N, ST PETERSBURG |
State: | FL |
Postal Code: | 337093859 |
Phone Number: | 7275441441 |
Fax Number: | 7275458263 |
NPI Enumeration Date: | 04/10/2007 |
NPI Last Update Date: | 04/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 0101248023 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |