Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD 043368-L | PA |
NPI | 1205806056 |
---|---|
Provider Name | Dr. Nikhil K Dave |
First Address | Charleroi, PA 15022-2141 |
Second Address | Charleroi, PA 15022-2141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D78056 | (02) | PA |