Individual
JWALANT RASIKLAL MODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.B.B.S.
Contact information
Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 584-4956
(513) 584-5571
Mailing address
PO BOX 636256, CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5504
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01074994A
IN
207RN0300X
Nephrology Physician
Primary
35 130445
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/14/2012
Last updated
08/14/2017
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