Provider Demographics
NPI:1225094212
Name:KOHUT, INGRID FOLLWEILER (DO)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:FOLLWEILER
Last Name:KOHUT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 W WASHINGTON SQ
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-3500
Mailing Address - Country:US
Mailing Address - Phone:215-829-6088
Mailing Address - Fax:215-829-6104
Practice Address - Street 1:230 W WASHINGTON SQ
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-3500
Practice Address - Country:US
Practice Address - Phone:215-829-6088
Practice Address - Fax:215-829-6104
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOSO12318207RX0202X
PAOS012318207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I51576Medicare UPIN
PA100368Medicare PIN