Individual
SANTPAL S. MAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5002
(740) 446-5883
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5002
(740) 446-5883
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
18878
WV
207RP1001X
Pulmonary Disease Physician
Primary
35-07-6701
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000185258
UNISON MEDICAID
OH
01
—
000000198558
ANTHEM BCBS
—
01
—
001714113
MOUNTAIN STATE BCBS
—
05
—
0081705000
—
WV
01
—
2069041
MOLINA MEDICAID
OH
01
—
290011997
RR MEDICARE
—
01
—
310917085095
CARESOURCE MEDICAID
OH
Enumeration date
05/15/2006
Last updated
10/26/2020
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