| Provider / Organization | NPI | Date Certified |
|---|---|---|
| AJHANI KESAVAN | 1043837271 | 2020-07-04 |
Ajhani Kesavan is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1043837271. Registration indicates Ajhani Kesavan is a provider of access to adult/geriatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, Family Medicine Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Family Medicine) (Allopathic & Osteopathic Physicians, Family Medicine) (Family Medicine, ) (Primary Care/Family Planning/APRN/PA, ) (Family Medicine, Allopathic & Osteopathic Physicians) Access to Adult/Geriatric Primary Care Providers (Allopathic & Osteopathic Physicians, Family Medicine) Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Family Medicine) (Allopathic & Osteopathic Physicians, Family Medicine) (Family Medicine, ) (Primary Care/Family Planning/APRN/PA, ) (Family Medicine, Allopathic & Osteopathic Physicians)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Ajhani Kesavan MD |
| Practice Office Address | 1411 N TAYLOR DR SHEBOYGAN, WI US |
| Practice Office Telephone | 9204964700 |
| Practice Office Fax | 6032287307 |
| Mailing Address | PO BOX 19070 GREEN BAY, WI 543079070 US |
| Business Telephone | 9204964700 |
| Direct Messaging Address [CDA/CCD/TXT] | [email protected] | Direct |
| Code | Practice | License No State |
|---|---|---|
| 207Q00000X | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians Family MedicineAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Family Medicine Allopathic & Osteopathic Physicians Family Medicine Family Medicine Primary Care/Family Planning/APRN/PA Family Medicine Allopathic & Osteopathic Physicians | RT-3658
NH |
| 207Q00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians Family MedicineAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Family Medicine Allopathic & Osteopathic Physicians Family Medicine Family Medicine Primary Care/Family Planning/APRN/PA Family Medicine Allopathic & Osteopathic Physicians | 82441-20
WI |
| 100252791 | MEDICAID | WI |