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Individual

SHIV SIMRUN KHOSLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
508 FULTON ST, DURHAM VA MEDICAL CENTER, BOX 182, DURHAM, NC 27705-3875
(919) 286-0411
Mailing address
508 FULTON ST, DURHAM VA MEDICAL CENTER, BOX 182, DURHAM, NC 27705-3875

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
190108
NC
390200000X
Student in an Organized Health Care Education/Training Program
245024
MA

Other

Enumeration date
07/14/2010
Last updated
07/29/2013
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