Healthcare Provider Details

I. General information

NPI: 1336229459
Provider Name (Legal Business Name): KARL DOGHRAMJI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 12/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 S 9TH ST SUITE 500
PHILADELPHIA PA
19107-6810
US

IV. Provider business mailing address

211 S 9TH ST SUITE 500
PHILADELPHIA PA
19107-6810
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-6175
  • Fax: 215-955-9783
Mailing address:
  • Phone: 215-955-6175
  • Fax: 215-955-9783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD025521E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberMD025521E
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number25MA09769300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: