Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | MD039897L | PA |
NPI | 1023098902 |
---|---|
Provider Name | Dr. Vithalbhai D Dhaduk |
First Address | Dunmore, PA 18512-2459 |
Second Address | Dunmore, PA 18512-2459 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B36244 | (02) | PA |