Provider Demographics
NPI:1477724771
Name:ACHWAL, MOHAN V (MD)
Entity Type:Individual
Prefix:
First Name:MOHAN
Middle Name:V
Last Name:ACHWAL
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 1:1221 SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-3257
Mailing Address - Country:US
Mailing Address - Phone:989-772-6700
Mailing Address - Fax:989-772-6807
Practice Address - Street 1:1221 SOUTH DR
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-3257
Practice Address - Country:US
Practice Address - Phone:989-772-6700
Practice Address - Fax:989-772-6807
Is Sole Proprietor?:No
Enumeration Date:2008-03-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301057434207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301057434OtherLICENSE
MIBA3159832OtherDEA