Individual
MOHAMAD KADKHODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 W LEHIGH AVE, SUITE B, PHILADELPHIA, PA 19132-2701
(215) 226-8800
(215) 226-8819
Mailing address
2450 W HUNTING PARK AVE FL 2, PHILADELPHIA, PA 19129-1302
(215) 926-9022
(215) 226-8286
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD 034718L
PA
208000000X
Pediatrics Physician
MD034718L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000692373
—
PA
01
—
0055553000
INDEPENDENCE BLUE CROSS
PA
01
—
10021A
KMHP
PA
01
—
114698
HIGHMARK BLUE SHIELD
PA
01
—
2098859
AETNA HMO
PA
01
—
5987421
AETNA PPO
PA
01
—
P00025017
RR MEDICARE
PA
Enumeration date
12/15/2005
Last updated
01/21/2020
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