Provider Demographics
NPI:1104110808
Name:KRIS MAHALINGAM MD INC
Entity type:Organization
Organization Name:KRIS MAHALINGAM MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
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:513-325-9025
Mailing Address - Street 1:4059 RETREAT DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-3099
Mailing Address - Country:US
Mailing Address - Phone:513-325-9025
Mailing Address - Fax:888-972-9271
Practice Address - Street 1:3310 MERCY HEALTH BLVD STE 110
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-1121
Practice Address - Country:US
Practice Address - Phone:513-215-5030
Practice Address - Fax:888-972-9271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35037592208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty