Provider Demographics
NPI:1023273687
Name:GUBBI, AJIT (DO)
Entity type:Individual
Prefix:DR
First Name:AJIT
Middle Name:
Last Name:GUBBI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5053 WOOSTER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45226-2326
Mailing Address - Country:US
Mailing Address - Phone:513-751-2273
Mailing Address - Fax:513-751-1848
Practice Address - Street 1:601 IVY GTWY STE 1100
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1898
Practice Address - Country:US
Practice Address - Phone:513-751-2273
Practice Address - Fax:513-751-1840
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY248054207V00000X
MI5101022136207VX0201X
OH34.010162207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0064024Medicaid
OHH609180OtherMEDICARE