Individual
DR. SOHAN KUMAR KHATIWADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
8701 BROADWAY, MERRILLVILLE, IN 46410-7035
(219) 738-4929
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(517) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01043463A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036076153
—
IL
05
—
200176820
—
IN
Enumeration date
06/12/2006
Last updated
08/04/2015
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