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General NPI Number Information
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NPI Number | 1487946562
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Entity Type | Individual
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Provider Name | PUNIYA KHATIWADA M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/09/2011
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 292 SAINT CHARLES WAY
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City | YORK
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State | PA
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Zip | 17402-4648
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Country | US
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Telephone | 717-851-6231
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Fax | 717-741-1719
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Provider Business Mailing Address
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Address Line | 601 MEMORY LN
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City | YORK
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State | PA
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Zip | 17402-2231
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Country | US
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Telephone | 717-851-1405
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MD458698
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 0101267875
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License Number State | VA
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