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Individual

DR. KAILAS D DAVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD FAAP

Contact information

Practice address
316 GOSHEN AVENUE, HAZLETON, PA 18201-0603
(570) 436-1635
(570) 434-1635
Mailing address
PO BOX 603, HAZLETON, PA 18201-0603
(570) 436-1635
(570) 436-1635

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD044209L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0012719660004
PA
01
001393
FIRST PRIORITY HEALTH
01
138534
MED PLUS UNISON
Enumeration date
01/12/2006
Last updated
02/10/2012
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