# OHIO DIGESTIVE AND LIVER ASSOCIATES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861925430
- **Authorized official:** DR. GHULAM MUJTABA M.D (OWNER)
- **Authorized official phone:** (917) 432-7333

## Contact information

- **Practice address:** 503 WOOSTER RD, MOUNT VERNON, OH 43050-1486
- **Practice address phone:** (917) 432-7333
- **Practice address fax:** (609) 798-0789
- **Mailing address:** 4619 SANDWICH CT, DUBLIN, OH 43016-8292
- **Mailing address phone:** (917) 432-7333
- **Mailing address fax:** (609) 798-0789

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | 35097038 | OH | Yes |

## Other

- **Enumeration date:** 04/10/2017
- **Last updated:** 04/10/2017