Individual
KISHIN K DODWANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 ABRAHAM FLEXNER WAY, LOUISVILLE, KY 40202-1818
(502) 587-4203
(502) 587-4155
Mailing address
2401 W UNIVERSITY AVE, RCS PROVIDER ENROLLMENT, MUNCIE, IN 47303-3428
(765) 747-3111
(765) 751-2757
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01057137A
IN
207L00000X
Anesthesiology Physician
38041
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200448690A
—
IN
05
—
64101058
—
KY
Enumeration date
05/11/2006
Last updated
06/01/2021
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