Provider Demographics
NPI:1831270818
Name:GENERAL & VASCULAR SURGICAL SPECIALISTS, INC.
Entity type:Organization
Organization Name:GENERAL & VASCULAR SURGICAL SPECIALISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHALINGAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-385-1919
Mailing Address - Street 1:11155 KENWOOD RD
Mailing Address - Street 2:SUITE 6C
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-1845
Mailing Address - Country:US
Mailing Address - Phone:513-385-1919
Mailing Address - Fax:513-385-6208
Practice Address - Street 1:11155 KENWOOD RD
Practice Address - Street 2:SUITE 6C
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-1845
Practice Address - Country:US
Practice Address - Phone:513-385-1919
Practice Address - Fax:513-385-6208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0067360OtherAETNA
OH0741620Medicaid
KY65931149Medicaid
OH1368191OtherUMWA
OH000000006345OtherANTHEM
OH1780184OtherUNITED HEALTHCARE
OH0741620Medicaid
OH1780184OtherUNITED HEALTHCARE
KY65931149Medicaid