Individual
MADHAN MOHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
850 RIVERVIEW RD, PINEVILLE, KY 40977-1430
(606) 337-6047
(606) 337-0925
Mailing address
850 RIVERVIEW RD, PO BOX 308, PINEVILLE, KY 40977-1430
(606) 337-6047
(606) 337-0925
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29667
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64296676
—
KY
Enumeration date
08/09/2006
Last updated
04/28/2008
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