Provider Demographics
NPI:1386751949
Name:MEHAN, MANEESH K (MD)
Entity type:Individual
Prefix:
First Name:MANEESH
Middle Name:K
Last Name:MEHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1020 WOODMAN DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45432-1446
Mailing Address - Country:US
Mailing Address - Phone:937-258-4570
Mailing Address - Fax:937-258-4573
Practice Address - Street 1:1020 WOODMAN DR
Practice Address - Street 2:SUITE 200
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45432-1446
Practice Address - Country:US
Practice Address - Phone:937-258-4570
Practice Address - Fax:937-258-4573
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2010-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH093450207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2983964Medicaid
OH4267361Medicare PIN