Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 01066254A | IN |
N | 207N00000X | Dermatologist | 35.091501 | OH |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 01066254A | IN |
N | 207NS0135X | Procedural Dermatology | 01066254A | IN |
NPI | 1104037886 |
---|---|
Provider Name | Dr. Ally-Khan Somani |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-5149 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 15/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200945370 | (05) | IN |