Individual
GAYATRI MADANMOHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 E WASHINGTON ST, MEDINA, OH 44256-2170
(330) 725-1000
Mailing address
970 E WASHINGTON ST, SUITE 2E, MEDINA, OH 44256-3332
(330) 723-0277
(330) 723-5679
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
35078710
OH
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
35078710
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2217318
—
OH
Enumeration date
03/04/2007
Last updated
01/27/2016
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