Provider Demographics
NPI:1174204408
Name:DAHAL, MOHAN
Entity type:Individual
Prefix:
First Name:MOHAN
Middle Name:
Last Name:DAHAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 BRYDEN RD STE 122
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4839
Mailing Address - Country:US
Mailing Address - Phone:614-681-0012
Mailing Address - Fax:614-525-0905
Practice Address - Street 1:700 BRYDEN RD STE 122
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4839
Practice Address - Country:US
Practice Address - Phone:614-681-0012
Practice Address - Fax:614-528-0905
Is Sole Proprietor?:No
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator