Basic Information
| Provider Information | |||||||||
| NPI: | 1982763918 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DINESH R GANDHI MD PA | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 301PINE ST NW | ||||||||
| Address2: | SUITE A | ||||||||
| City: | HARTSELLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567735469 | ||||||||
| FaxNumber: | 2567735425 | ||||||||
| Practice Location | |||||||||
| Address1: | 301 PINE ST NW | ||||||||
| Address2: | SUITE A | ||||||||
| City: | HARTSELLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356402338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567735469 | ||||||||
| FaxNumber: | 2567735425 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | GANDHI | ||||||||
| AuthorizedOfficialFirstName: | DINESH | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2567735469 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 7119 | AL | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.