Provider Demographics
NPI:1376639104
Name:GAHLOT, LUXMI (MD)
Entity Type:Individual
Prefix:DR
First Name:LUXMI
Middle Name:
Last Name:GAHLOT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LECOM PL
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-2571
Mailing Address - Country:US
Mailing Address - Phone:814-868-2507
Mailing Address - Fax:814-868-2522
Practice Address - Street 1:5401 PEACH ST STE 3300
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-2601
Practice Address - Country:US
Practice Address - Phone:814-868-7840
Practice Address - Fax:814-868-2139
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22477207L00000X
PAMD423793207L00000X
OH35.088789207LP2900X
OH35-088789207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1031123800001Medicaid
WV3810007980Medicaid
OH2722718Medicaid
WVP00404720OtherRR MEDICARE
OH2722718Medicaid
OHH122042Medicare PIN
PA444371YGC9Medicare PIN
WV4202724Medicare PIN
OH4201471Medicare PIN
WV4202721Medicare PIN