Individual
IMAD GEORGE KOJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3903 S 7TH ST, STE 2E, TERRE HAUTE, IN 47802-5710
(812) 235-7370
(812) 235-7570
Mailing address
3903 S 7TH ST STE 2E, TERRE HAUTE, IN 47802-5710
(812) 235-7370
(812) 235-7570
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
01048808A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000389741
ANTHEM PIN
IN
05
—
200230910
—
IN
01
—
P00283648
RAILROAD MEDICARE
IN
Enumeration date
10/27/2005
Last updated
05/17/2023
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