Ohio Digestive and Liver Associates LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

35097038 Issued in OH

Legal business name

OHIO DIGESTIVE AND LIVER ASSOCIATES LLC

Practice address

503 Wooster Rd
Mount Vernon, OH 43050-1486

Phone

(917) 432-7333

Fax

(609) 798-0789

NPI assigned

Apr 10, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Ghulam Mujtaba, M.D

Title

Owner

Phone

(917) 432-7333

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491782400000",
    "number": "1861925430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4619 SANDWICH CT",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430168292",
            "telephone_number": "917-432-7333",
            "fax_number": "609-798-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 WOOSTER RD",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430501486",
            "telephone_number": "917-432-7333",
            "fax_number": "609-798-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO DIGESTIVE AND LIVER ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-10",
        "last_updated": "2017-04-10",
        "status": "A",
        "authorized_official_last_name": "MUJTABA",
        "authorized_official_first_name": "GHULAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-432-7333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35097038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.