Provider Demographics
NPI:1134362403
Name:GANDHI, RISHI KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:RISHI
Middle Name:KUMAR
Last Name:GANDHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:999 BRUBAKER DR STE 3
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-3505
Mailing Address - Country:US
Mailing Address - Phone:937-668-9850
Mailing Address - Fax:937-668-8668
Practice Address - Street 1:999 BRUBAKER DR STE 3
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-3505
Practice Address - Country:US
Practice Address - Phone:937-668-9850
Practice Address - Fax:937-668-8668
Is Sole Proprietor?:No
Enumeration Date:2009-04-15
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.097602207N00000X, 207NS0135X, 207ND0101X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology