Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 47504 | KY |
N | 111NI0900X | Internist | 47504 | KY |
N | 207R00000X | Internist | R2754 | KY |
N | 111NI0900X | Internist | R2754 | KY |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 47504 | KY |
N | 207RC0000X | Internist - Cardiovascular Disease | 47504 | KY |
NPI | 1922397363 |
---|---|
Provider Name | Dr. Amaninderapal S Ghotra |
First Address | Cincinnati, OH 45263-5283 |
Second Address | Edgewood, KY 41017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2011 |
Last Update Date | 28/10/2021 |