Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD459100 | PA |
Y | 208600000X | Surgeon | MD459100 | PA |
NPI | 1003104274 |
---|---|
Provider Name | Dr. Anirudh Kohli |
First Address | Philadelphia, PA 19107-5563 |
Second Address | Philadelphia, PA 19107-5563 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2011 |
Last Update Date | 30/08/2016 |