Individual
DR. DARRELL J KOHLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1015 S LINCOLN RD, ESCANABA, MI 49829-2100
(906) 786-5181
(906) 786-7403
Mailing address
1015 S LINCOLN RD, ESCANABA, MI 49829-2100
(906) 474-6003
(906) 786-7403
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
052758
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102758320
—
MI
01
—
1497792386
UP OPHTHALMOLOGY GR NPI
MI
01
—
180012681
RAILROAD MEDICARE
MI
01
—
180B160140
BLUE CROSS BLUE SHIELD
MI
Enumeration date
07/18/2005
Last updated
06/22/2020
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