MEDICARE: KISHOR S DABHI MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	0101057702	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831269703
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KISHOR S DABHI MD PC

Provider Business Mailing Address
First Line	:	3628 BOULEVARD
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-1342
Country	:	US
Telephone Number	:	804-526-5850
Fax Number	:	804-520-7312

Provider Business Practice Location Address
First Line	:	3628 BOULEVARD
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-1342
Country	:	US
Telephone Number	:	804-526-5850
Fax Number	:	804-520-7312

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KISHOR S DABHI
Credential	:	M.D.
Telephone Number	:	804-526-5850

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	03/25/2008

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