Individual
MADEERA KATHPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
805 6TH AVE W STE 100, HENDERSONVILLE, NC 28739-4160
(828) 696-1330
(828) 696-1075
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-5046
(210) 916-0330
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
OT012183
PA
2085R0001X
Radiation Oncology Physician
Primary
2018-02951
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT012183
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
PA
Enumeration date
08/31/2009
Last updated
04/16/2021
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