Individual
DILIP P GHODASARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
217 S 3RD ST, DANVILLE, KY 40422-1823
(859) 335-9041
(859) 335-9072
Mailing address
4 SHAMBLIN PL, CHARLESTON, WV 25314-2154
(304) 744-4086
(304) 466-2928
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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