Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | MTL001434 | DC |
NPI | 1609297894 |
---|---|
Provider Name | Indranil Kushare |
First Address | Washington, DC 20010-2269 |
Second Address | Washington, DC 20010-2916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2013 |
Last Update Date | 15/12/2013 |