Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 0101264320 | VA |
Y | 111NI0900X | Internist | 0101264320 | VA |
NPI | 1003299389 |
---|---|
Provider Name | Palak Kachhadia |
First Address | Portsmouth, VA 23707-0068 |
Second Address | Suffolk, VA 23434 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2015 |
Last Update Date | 16/07/2018 |