1225089949 NPI number — INDER V KHOKHA MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225089949 NPI number — INDER V KHOKHA MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

KHOKHA

Provider First Name:

INDER

Provider Middle Name:

V

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1225089949

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

07/25/2022

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 380

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

CAVALIER

Provider Business Mailing Address State Name:

ND

Provider Business Mailing Address Postal Code:

58220-0380

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

701-265-8461

Provider Business Mailing Address Fax Number:

701-265-6269

Provider First Line Business Practice Location Address:

301 MOUNTAIN ST E

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

CAVALIER

Provider Business Practice Location Address State Name:

ND

Provider Business Practice Location Address Postal Code:

58220-4015

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

701-265-8461

Provider Business Practice Location Address Fax Number:

701-265-6269

Provider Enumeration Date:

05/15/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 208600000X , with the licence number:  9468 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 766S0KH . This is a "MNBS #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
• Identifier: HP64473 . This is a "ND MEDICARE #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
• Identifier: 133284 . This is a "UCARE #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
• Identifier: 26784 . This is a "NDBS #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
• Identifier: 762S3KH . This is a "MNBS #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
• Identifier: 15458 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
• Identifier: 2435573 . This is a "AMERICA'S PPO - ARAZ #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
• Identifier: 766S2KH . This is a "MNBS #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
• Identifier: DA9061047213 . This is a "PREFERRED ONE #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
• Identifier: 568592300 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
• Identifier: 12756 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
• Identifier: 1701656 . This is a "MEDICA #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".