Individual
AISHA B GARGOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
160 S TUTTLE RD, SPRINGFIELD, OH 45505-1553
(937) 523-9690
(937) 523-9698
Mailing address
160 S TUTTLE RD, SPRINGFIELD, OH 45505-1553
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036.124871
IL
207Q00000X
Family Medicine Physician
Primary
35.126514
OH
207Q00000X
Family Medicine Physician
4301088430
MI
Other
Enumeration date
05/14/2007
Last updated
06/25/2015
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