Provider Demographics
NPI:1437547197
Name:ASAHA, DAVID
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ASAHA
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 1:5699 FOREST ASH LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3700
Mailing Address - Country:US
Mailing Address - Phone:614-282-8164
Mailing Address - Fax:
Practice Address - Street 1:5699 FOREST ASH LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3700
Practice Address - Country:US
Practice Address - Phone:614-282-8164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH158141164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH158141OtherOHIO BOARD OF NURSING
OH158141OtherOHIO BOARD OF NURSING