Individual
PRATIK M VAISHNAV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 MATTHEW ST, EMERGENCY DEPARTMENT, MARIETTA, OH 45750-1635
(740) 376-1939
(740) 374-1693
Mailing address
PO BOX 449, MARIETTA, OH 45750-0449
(740) 374-4500
(740) 374-5887
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35087579
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2653203
—
OH
05
—
3810005301
—
WV
01
—
P01036918
RAILROAD MEDICARE PTAN
OH
Enumeration date
05/15/2006
Last updated
11/08/2012
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