Provider Demographics
NPI:1225089949
Name:KHOKHA, INDER V (MD)
Entity Type:Individual
Prefix:
First Name:INDER
Middle Name:V
Last Name:KHOKHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 380
Mailing Address - Street 2:
Mailing Address - City:CAVALIER
Mailing Address - State:ND
Mailing Address - Zip Code:58220-0380
Mailing Address - Country:US
Mailing Address - Phone:701-265-8461
Mailing Address - Fax:701-265-6269
Practice Address - Street 1:301 MOUNTAIN ST E
Practice Address - Street 2:
Practice Address - City:CAVALIER
Practice Address - State:ND
Practice Address - Zip Code:58220-4015
Practice Address - Country:US
Practice Address - Phone:701-265-8461
Practice Address - Fax:701-265-6269
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND9468208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND766S0KHOtherMNBS #
NDHP64473OtherND MEDICARE #
ND133284OtherUCARE #
ND26784OtherNDBS #
ND762S3KHOtherMNBS #
ND15458Medicaid
ND2435573OtherAMERICA'S PPO - ARAZ #
ND766S2KHOtherMNBS #
NDDA9061047213OtherPREFERRED ONE #
ND568592300Medicaid
ND12756Medicaid
ND1701656OtherMEDICA #
ND12756Medicaid
ND766S2KHOtherMNBS #
ND762S3KHOtherMNBS #