Healthcare Provider Details

I. General information

NPI: 1851557573
Provider Name (Legal Business Name): ARJUN KHOSLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 04/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1974 SPROUL RD STE 106
BROOMALL PA
19008
US

IV. Provider business mailing address

140 W GERMANTOWN PIKE STE 250
PLYMOUTH MEETING PA
19462-1421
US

V. Phone/Fax

Practice location:
  • Phone: 610-259-3000
  • Fax: 610-259-3042
Mailing address:
  • Phone: 484-530-0205
  • Fax: 484-530-0209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD452535
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: