Provider Demographics
NPI:1568488807
Name:MAHAJAN, SANGEETA T (MD)
Entity Type:Individual
Prefix:
First Name:SANGEETA
Middle Name:T
Last Name:MAHAJAN
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 1:11100 EUCLID AVE # MAC5034
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1716
Mailing Address - Country:US
Mailing Address - Phone:216-844-4906
Mailing Address - Fax:
Practice Address - Street 1:5850 LANDERBROOK DR STE 210
Practice Address - Street 2:
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124-4071
Practice Address - Country:US
Practice Address - Phone:216-844-3941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.086378207VF0040X
OH35-086378207V00000X
OH350856378207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7988707OtherAETNA
OH000000221323OtherUNISON
OH221323OtherUNISON
OH2571248Medicaid
OH363797OtherWELLCARE
OHP00281367OtherRAILROAD MEDICARE
OH000000509174OtherANTHEM
OH738074OtherBUCKEYE
OHP00374601OtherRAILROAD MEDICARE
OH000000221323OtherUNISON
OH363797OtherWELLCARE
OHMA4164781Medicare PIN