Provider Demographics
NPI:1235931122
Name:SONDAGAR, MAUSAM (MBBS)
Entity type:Individual
Prefix:
First Name:MAUSAM
Middle Name:
Last Name:SONDAGAR
Suffix:
Gender:
Credentials:MBBS
Other - Prefix:
Other - First Name:MAUSAM
Other - Middle Name:ASHOKBHAI
Other - Last Name:KALSARIYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 S WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38701-4719
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38701-4719
Practice Address - Country:US
Practice Address - Phone:763-568-6038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program