Provider Demographics
NPI:1083974299
Name:QAMAR, KHOLA (MD)
Entity Type:Individual
Prefix:
First Name:KHOLA
Middle Name:
Last Name:QAMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 HOSPITAL DR STE 307
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201-5018
Mailing Address - Country:US
Mailing Address - Phone:802-447-4555
Mailing Address - Fax:802-447-0996
Practice Address - Street 1:140 HOSPITAL DR STE 307
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201
Practice Address - Country:US
Practice Address - Phone:802-447-4555
Practice Address - Fax:802-447-0996
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042.0014066207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT042.0014066OtherSTATE LICENSE