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General NPI Number Information
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NPI Number | 1982903910
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Entity Type | Organization
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Legal Business Name | ASHOK K. WADHERA MD PA
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Dates
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Enumeration Date | 03/16/2011
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Last Update Date | 03/16/2011
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Provider Practice Location Address
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Address Line | 304 W 23RD ST
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City | PANAMA CITY
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State | FL
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Zip | 32405-4506
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Country | US
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Telephone | 850-785-1700
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Fax | 850-785-1759
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Provider Business Mailing Address
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Address Line | 304 WEST 23RD STREET
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City | PANAMA CITY
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State | FL
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Zip | 32405
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Country | US
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Telephone | 850-785-1700
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Fax | 850-785-1759
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Authorized Official
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Title or Position | OWNER
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Name | DR. ASHOK WADHERA
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Credential | MD
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Telephone | 850-785-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME74247
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License Number State | FL
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