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Individual

DR. KEVIN MOHTASHEMI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9998 CROSSPOINT BLVD STE 200, INDIANAPOLIS, IN 46256-3307
(317) 579-2150
(317) 579-2130
Mailing address
9998 CROSSPOINT BLVD STE 200, INDIANAPOLIS, IN 46256-3307
(317) 579-2150
(317) 579-2130

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101247492
VA
2085R0202X
Diagnostic Radiology Physician
Primary
01080213A
IN
2085R0202X
Diagnostic Radiology Physician
16096
NV
2085R0202X
Diagnostic Radiology Physician
C138973
CA
2085R0202X
Diagnostic Radiology Physician
D70173
MD
2085R0202X
Diagnostic Radiology Physician
MD038432
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1831324011
NV
Enumeration date
05/18/2009
Last updated
01/09/2024
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