Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 35046068 | OH |
Y | 111NI0900X | Internist | 35046068 | OH |
N | 207RG0300X | Geriatric Medicine | 35046068 | OH |
NPI | 1114926987 |
---|---|
Provider Name | Santosh Khurma |
First Address | Xenia, OH 45385-2666 |
Second Address | Xenia, OH 45385 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 19/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000012488 | ANTHEM (01) | OH |
0687109 | (05) | OH |
110089376 | RAILROAD MEDICARE (01) | OH |
A80273 | (02) | |
P00432943 | RAILROAD MEDICARE (01) | OH |