Provider Demographics
NPI:1053345306
Name:DHADUVAI, ASHOK KUMAR KUMAR (MD)
Entity type:Individual
Prefix:
First Name:ASHOK KUMAR
Middle Name:KUMAR
Last Name:DHADUVAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 US HIGHWAY 301
Mailing Address - Street 2:
Mailing Address - City:ELLENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34222-2007
Mailing Address - Country:US
Mailing Address - Phone:941-729-6818
Mailing Address - Fax:941-723-9449
Practice Address - Street 1:2901 US HIGHWAY 301
Practice Address - Street 2:
Practice Address - City:ELLENTON
Practice Address - State:FL
Practice Address - Zip Code:34222-2007
Practice Address - Country:US
Practice Address - Phone:941-729-6818
Practice Address - Fax:941-723-9449
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0060506207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057742100Medicaid
FL57742100Medicaid
FL14081Medicare PIN
FLD39084Medicare UPIN