Individual
GULAM MUKHDOMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
083053
OH
174400000X
Specialist
Primary
083053
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2437018
—
OH
Enumeration date
07/01/2006
Last updated
11/20/2018
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