Provider Demographics
NPI:1982700886
Name:MAHESH SURGICAL ASSOCIATES INC
Entity Type:Organization
Organization Name:MAHESH SURGICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENKRE
Authorized Official - Middle Name:G
Authorized Official - Last Name:MAHESH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-222-8444
Mailing Address - Street 1:120 N MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2248
Mailing Address - Country:US
Mailing Address - Phone:508-222-8444
Mailing Address - Fax:508-226-3713
Practice Address - Street 1:120 N MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2248
Practice Address - Country:US
Practice Address - Phone:508-222-8444
Practice Address - Fax:508-226-3713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59809208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9724974Medicaid
MAM20280Medicare ID - Type Unspecified
MA9724974Medicaid