Individual
DR. NIKOLOZ KOSHKELASHVILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-6500
Mailing address
701 N STATE OF FRANKLIN RD, STE 2, JOHNSON CITY, TN 37604-3645
(215) 456-6500
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
63445
TN
207RI0011X
Interventional Cardiology Physician
Primary
63445
TN
Other
Enumeration date
07/23/2013
Last updated
07/22/2021
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