Provider Demographics
NPI:1902884455
Name:JOBALIA, NILESH B (MD)
Entity Type:Individual
Prefix:
First Name:NILESH
Middle Name:B
Last Name:JOBALIA
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:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45012-0001
Mailing Address - Country:US
Mailing Address - Phone:513-454-2277
Mailing Address - Fax:513-454-2288
Practice Address - Street 1:3145 HAMILTON MASON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-8557
Practice Address - Country:US
Practice Address - Phone:513-454-2277
Practice Address - Fax:513-454-2288
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-062727207L00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0154292Medicaid
OH0883173Medicare PIN
OH0154292Medicaid