Provider Demographics
NPI:1093957276
Name:OHIO VALLEY DIGESTIVE & NUTRITION CENTER
Entity Type:Organization
Organization Name:OHIO VALLEY DIGESTIVE & NUTRITION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HIMANSHU
Authorized Official - Middle Name:P
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-264-2686
Mailing Address - Street 1:1805 SINCLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43953-3327
Mailing Address - Country:US
Mailing Address - Phone:740-264-2686
Mailing Address - Fax:740-266-4981
Practice Address - Street 1:1805 SINCLAIR AVE
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953-3327
Practice Address - Country:US
Practice Address - Phone:740-264-2686
Practice Address - Fax:740-266-4981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35066332207RG0100X
WV17863207RG0100X
PAMD069935L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty