Shivaprasad, Mabbu Gajapathy
Shivaprasad, Mabbu Gajapathy is an individual health care provider with primary practice located at Logan Family Medical Center Llc 2210 Timber Trail, Bellefontaine OH 43311. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Shivaprasad, Mabbu Gajapathy can be contacted via phone (937) 593-3151.Contact Information
Primary practice address
Logan Family Medical Center Llc 2210 Timber Trail
Bellefontaine OH 43311
Phone: (937) 593-3151
Fax: (937) 593-5438
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 35-072257 | Ohio |
Profile Details
| NPI number | 1083795850 |
|---|---|
| LBN Legal business name | Shivaprasad, Mabbu Gajapathy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 18th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083795850 | NPPES |
| Ohio | MEDICAID | 2017373 |
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