Individual
SANJAY MARDOLKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4439 STATE ROUTE 159 STE G10, CHILLICOTHE, OH 45601-7708
(740) 779-4300
(740) 779-4391
Mailing address
4439 STATE ROUTE 159 STE G10, CHILLICOTHE, OH 45601-7708
(740) 779-4300
(740) 779-4391
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2015-01700
NC
208000000X
Pediatrics Physician
Primary
35.077587
OH
2080A0000X
Pediatric Adolescent Medicine Physician
19900
WV
2080A0000X
Pediatric Adolescent Medicine Physician
35077587
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346237385
—
NC
05
—
2143040
—
OH
05
—
6700083000
—
WV
05
—
NC2514
—
SC
Enumeration date
10/04/2005
Last updated
03/17/2018
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