Provider Demographics
NPI:1679546618
Name:KEJRIWAL, ASHOK (MD)
Entity type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:
Last Name:KEJRIWAL
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 1:435 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-3085
Mailing Address - Country:US
Mailing Address - Phone:513-887-9600
Mailing Address - Fax:513-454-2705
Practice Address - Street 1:435 PARK AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-3085
Practice Address - Country:US
Practice Address - Phone:513-887-9600
Practice Address - Fax:513-454-2705
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35064535207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0938105Medicaid
OHAS4019881Medicare ID - Type Unspecified
OH0938105Medicaid