Organization
OHIO DIGESTIVE AND LIVER ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GHULAM MUJTABA M.D (OWNER)
(917) 432-7333
Entity
Organization
Contact information
Practice address
503 WOOSTER RD, MOUNT VERNON, OH 43050-1486
(917) 432-7333
(609) 798-0789
Mailing address
4619 SANDWICH CT, DUBLIN, OH 43016-8292
(917) 432-7333
(609) 798-0789
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
35097038
OH
Other
Enumeration date
04/10/2017
Last updated
04/10/2017
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