Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | 210443 | MA |
Y | 207RG0300X | Geriatric Medicine | ME85397 | FL |
NPI | 1134101124 |
---|---|
Provider Name | Dr. Karl Marx Dhana |
First Address | Wellington, FL 33467-8069 |
Second Address | West Palm Beach, FL 33417-8023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BD7427152 | DEA LICENSE NUMBER (01) | FL |
H91275 | (02) | FL |
ME85397 | MEDICAL LICENSE - FLORIDA (01) | FL |