Provider Demographics
NPI:1790750974
Name:MAHESH, VINIT KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:VINIT
Middle Name:KUMAR
Last Name:MAHESH
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 1:502 GOVERNORS DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5126
Mailing Address - Country:US
Mailing Address - Phone:256-533-0833
Mailing Address - Fax:256-533-0855
Practice Address - Street 1:502 GOVERNORS DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5126
Practice Address - Country:US
Practice Address - Phone:256-533-0833
Practice Address - Fax:256-533-0855
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL156462080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051026590OtherBLUE CROSS PROVIDER #
ALMA000026590Medicaid
AL051026590OtherBLUE CROSS PROVIDER #