Healthcare Provider Details

I. General information

NPI: 1730198425
Provider Name (Legal Business Name): SUJATA KHOSLA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SUJATA KALHAN M.D

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35000 KAISER CT
WILLOUGHBY OH
44094-3382
US

IV. Provider business mailing address

6760 GATES MILLS BLVD
GATES MILLS OH
44040-9305
US

V. Phone/Fax

Practice location:
  • Phone: 440-269-4600
  • Fax:
Mailing address:
  • Phone: 216-272-5524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.071300
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: