Individual
AMITA GHOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1106 4TH AVE, MOLINE, IL 61265
(563) 336-3000
(563) 327-2045
Mailing address
500 W RIVER DR, DAVENPORT, IA 52801-1014
(563) 336-3000
(563) 327-2045
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036145083
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036145083
—
IL
05
—
1376925289
—
IA
Enumeration date
06/27/2015
Last updated
07/24/2018
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