Provider Demographics
NPI:1255365045
Name:GANDHI, ASHISH D (MD)
Entity type:Individual
Prefix:DR
First Name:ASHISH
Middle Name:D
Last Name:GANDHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ASHISH
Other - Middle Name:
Other - Last Name:GANDHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:451 ANDOVER ST STE G11
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5044
Mailing Address - Country:US
Mailing Address - Phone:978-208-0285
Mailing Address - Fax:978-655-7019
Practice Address - Street 1:451 ANDOVER ST STE G11
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5044
Practice Address - Country:US
Practice Address - Phone:978-208-0285
Practice Address - Fax:978-655-7019
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA208345207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAH29078Medicare UPIN
MAA34692Medicare PIN