Provider Demographics
NPI:1225394703
Name:MAHAJAN, KEDAR
Entity Type:Individual
Prefix:DR
First Name:KEDAR
Middle Name:
Last Name:MAHAJAN
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:MELLEN CTR
Mailing Address - Street 2:9500 EUCLID AVE MAIL CODE U-10
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-636-1158
Mailing Address - Fax:216-445-6259
Practice Address - Street 1:MELLEN CTR
Practice Address - Street 2:9500 EUCLID AVE MAIL CODE U-10
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-636-1158
Practice Address - Fax:216-445-6259
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1285912084N0400X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology