Individual
ASHUTOSH KUMAR MAHAJAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
105 W 8TH AVE STE 7010, SPOKANE, WA 99204-2312
(509) 474-6560
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M6269
TX
207RN0300X
Nephrology Physician
M6269
TX
207RN0300X
Nephrology Physician
Primary
MD61367747
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203772301
—
TX
01
—
P00755700
MEDICARE RAILROAD
TX
Enumeration date
06/09/2006
Last updated
05/31/2023
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