Individual
ASHUTOSH MANOJKUMAR SHUKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 273-9180
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 273-9180
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME110506
FL
207RN0300X
Nephrology Physician
T2009-080
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004642100
—
FL
Enumeration date
04/12/2007
Last updated
06/22/2012
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