Individual
SANJIV KHETARPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4665 BELPAR ST NW, CANTON, OH 44718
(330) 493-1480
(330) 493-6805
Mailing address
PO BOX 36329, CANTON, OH 44735
(330) 493-1480
(330) 493-6805
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
35063232
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000126856
ANTHEM
—
05
—
0904758
—
OH
01
—
100005648
RAILROAD MEDICARE
—
01
—
100235
KAISER
—
01
—
2217260
AETNA
—
01
—
2900159
UNITED HEALTHCARE
—
01
—
87738
QUAL CHOICE
—
Enumeration date
01/22/2007
Last updated
12/19/2022
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