Provider Demographics
NPI:1053867085
Name:GOHE, MAHAD
Entity Type:Individual
Prefix:
First Name:MAHAD
Middle Name:
Last Name:GOHE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 PARK MEADOWS DR APT 202
Mailing Address - Street 2:
Mailing Address - City:WAITE PARK
Mailing Address - State:MN
Mailing Address - Zip Code:56387-1843
Mailing Address - Country:US
Mailing Address - Phone:320-455-1730
Mailing Address - Fax:
Practice Address - Street 1:390 PARK MEADOWS DR APT 202
Practice Address - Street 2:
Practice Address - City:WAITE PARK
Practice Address - State:MN
Practice Address - Zip Code:56387-1843
Practice Address - Country:US
Practice Address - Phone:320-455-1730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-30
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health