Individual
DILIP P GHODASARA
Active
Individual
DILIP P GHODASARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
18267
WV
207R00000X
Internal Medicine Physician
Primary
35.077664
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000384513
ANTHEM
KY
01
—
001716933
MT. STATE BCBS
WV
05
—
0078302000
—
WV
01
—
1036692
BWC
WV
05
—
2060442
—
OH
05
—
4401035
—
TN
01
—
P00212624
RR-MEDICARE
KY
Enumeration date
07/15/2006
Last updated
04/20/2015
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