Gulam Mukhdomi, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

083053

Practice address

4215 Gantz Rd.
Grove City, OH 43123

Phone

(614) 539-4425

Fax

(614) 539-5400

NPI assigned

Jul 1, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cincinnati Centers for Pain Relief Inc

  • Pain Medicine Physician
  • Hamilton, OH
  • NPI 1316981616
  NPD (past)
• Lakota Medical, LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Hamilton, OH
  • NPI 1730192097
  NPD (past)
• Osu Health System Anesthesia

  • Anesthesiology Physician
  • Columbus, OH
  • NPI 1174581185
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1184653214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 GANTZ RD.",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "43123",
            "telephone_number": "614-539-4425",
            "fax_number": "614-539-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 GANTZ RD.",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "43123",
            "telephone_number": "614-539-4425",
            "fax_number": "614-539-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKHDOMI",
        "first_name": "GULAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": "083053",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "083053",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2437018",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mount Carmel Health System
• Mount Carmel Healthproviders Inc (Mount Carmel Urgent Care)
• Mount Carmel Urgent Care
• James Garret Mouser, M.D.
• Cecilia A Moy, DDS
• Muku Logistics LLC
• Sheheryar Munir, MD
• Diane Murphy
• Kamilah Muse
• My Family Dental

• Specialist in Grove City, OH
• Providers in Grove City, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.