Provider Demographics
NPI:1609005578
Name:GANGADHARAMURTHY, DAKSHIN (MD)
Entity type:Individual
Prefix:
First Name:DAKSHIN
Middle Name:
Last Name:GANGADHARAMURTHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DAKSHINAMURTHY
Other - Middle Name:
Other - Last Name:GANGADHARAMURTHY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7677 YANKEE STREET
Mailing Address - Street 2:SUITE 140
Mailing Address - City:WASHINGTON TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45459
Mailing Address - Country:US
Mailing Address - Phone:937-424-0012
Mailing Address - Fax:937-424-0077
Practice Address - Street 1:7677 YANKEE STREET
Practice Address - Street 2:SUITE 140
Practice Address - City:WASHINGTON TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45459
Practice Address - Country:US
Practice Address - Phone:937-424-0012
Practice Address - Fax:937-424-0077
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-13
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.138598207RC0000X, 207RC0000X
TN61443207R00000X, 208M00000X
MS26693208M00000X
MA247776208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist