Basic Information
| Provider Information | |||||||||
| NPI: | 1811170533 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAS | ||||||||
| FirstName: | ARJUN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2109 HUGHES DR | ||||||||
| Address2: | SUITE 920 | ||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194792650 | ||||||||
| FaxNumber: | 4194792655 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 S CALIFORNIA AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606081729 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7732576552 | ||||||||
| FaxNumber: | 7732576027 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2007 | ||||||||
| LastUpdateDate: | 10/09/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 125-050035 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | 096006 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 3111644 | 05 | OH | MEDICAID |