Individual
ABHAYA KHATIWADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2600
Mailing address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2600
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
2024010255
MO
390200000X
Student in an Organized Health Care Education/Training Program
MT224076
PA
Other
Enumeration date
05/21/2021
Last updated
09/11/2024
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