Healthcare Provider Details

I. General information

NPI: 1245727643
Provider Name (Legal Business Name): SOHIL GOLWALA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2018
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 W WASHINGTON SQ FL 3
PHILADELPHIA PA
19106-3500
US

IV. Provider business mailing address

701 E MARSHALL ST
WEST CHESTER PA
19380-4412
US

V. Phone/Fax

Practice location:
  • Phone: 215-829-5064
  • Fax: 215-829-3081
Mailing address:
  • Phone: 610-431-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD474245
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: