Provider Demographics
NPI:1437146677
Name:MALHOTRA, ARVIND K (MD)
Entity Type:Individual
Prefix:
First Name:ARVIND
Middle Name:K
Last Name:MALHOTRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-4011
Mailing Address - Country:US
Mailing Address - Phone:419-289-2696
Mailing Address - Fax:419-289-8267
Practice Address - Street 1:1025 CENTER ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-4011
Practice Address - Country:US
Practice Address - Phone:419-289-2696
Practice Address - Fax:419-289-8267
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350492812085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0642737Medicaid
OH0642737Medicaid
OHD98038Medicare UPIN