Individual
DR. MUKESH M GANDHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
409 E GEORGIA ST, WOODRUFF, SC 29388-1915
(864) 476-7068
(864) 476-7069
Mailing address
409 E GEORGIA ST, WOODRUFF, SC 29388-1915
(864) 476-7068
(864) 476-7069
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
14842
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110121586
RR MEDICARE
SC
05
—
148423
—
SC
01
—
1851467203
GROUP NPI NUMBER
SC
01
—
570958219
BC/BS
SC
01
—
DF4780
RR MEDICARE
SC
01
—
E691833365
MEDICARE PTAN
SC
Enumeration date
06/13/2005
Last updated
03/19/2012
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