Provider Demographics
NPI:1669437398
Name:GOVANI, MAHENDRA V (MD)
Entity type:Individual
Prefix:
First Name:MAHENDRA
Middle Name:V
Last Name:GOVANI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8330 NAAB RD
Mailing Address - Street 2:SUITE 234
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5925
Mailing Address - Country:US
Mailing Address - Phone:317-875-0084
Mailing Address - Fax:317-876-5580
Practice Address - Street 1:8935 N MERIDIAN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5379
Practice Address - Country:US
Practice Address - Phone:317-574-4747
Practice Address - Fax:317-574-4737
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2009-07-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01051268207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200247630Medicaid
INP00709798Medicare PIN
IN200247630Medicaid
IN796270QQMedicare PIN