Provider Demographics
NPI:1679838510
Name:MANDALIYA, ROHAN HITENDRA (MD)
Entity Type:Individual
Prefix:
First Name:ROHAN
Middle Name:HITENDRA
Last Name:MANDALIYA
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 1:300 20TH AVE N STE 403
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5180
Mailing Address - Country:US
Mailing Address - Phone:615-284-7261
Mailing Address - Fax:615-284-7502
Practice Address - Street 1:4230 HARDING PIKE STE 530
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2094
Practice Address - Country:US
Practice Address - Phone:615-222-1222
Practice Address - Fax:615-222-1200
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD043353207RG0100X
TN61476207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology