Provider Demographics
NPI:1588719868
Name:BOHJWANI, MOHEN (MD, LFAPA)
Entity type:Individual
Prefix:DR
First Name:MOHEN
Middle Name:
Last Name:BOHJWANI
Suffix:
Gender:M
Credentials:MD, LFAPA
Other - Prefix:DR
Other - First Name:MOHAN
Other - Middle Name:
Other - Last Name:BHOJWANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1121 WHEATFIELD CT
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-4742
Mailing Address - Country:US
Mailing Address - Phone:937-689-0290
Mailing Address - Fax:937-689-0290
Practice Address - Street 1:24 JOLIET ST
Practice Address - Street 2:
Practice Address - City:DYER
Practice Address - State:IN
Practice Address - Zip Code:46311-1705
Practice Address - Country:US
Practice Address - Phone:219-864-2232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY248642084P0800X
VA01010372642084P0800X
OH350532012084P0800X
PAMD-035286-E2084P0800X
IN01034729A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0169099Medicaid
IN200465490Medicaid
PA0015707690004Medicaid
IN200465490Medicaid