Individual
KAUSTUBH KAILASH SHRIVASTAVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
30 E APPLE ST STE NW3300, DAYTON, OH 45409-2939
(937) 208-8394
(937) 208-8388
Mailing address
61 LEDGELAWN AVE, BAR HARBOR, ME 04609-1303
(567) 210-0190
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35.130715
OH
207R00000X
Internal Medicine Physician
MD19979
ME
Other
Enumeration date
10/28/2011
Last updated
07/21/2022
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