Individual
DR. SANJAY MOHANTY
Active
Individual
DR. SANJAY MOHANTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01082407A
IN
208600000X
Surgery Physician
4301099184
MI
208C00000X
Colon & Rectal Surgery Physician
Primary
01082407A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
233690095
MEDICARE PTAN
IN
05
—
300027159
—
IN
Enumeration date
06/22/2011
Last updated
08/14/2023
Update your record
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