Provider Demographics
NPI:1417949298
Name:KAHLE, POCHNA CHOTIKUL (MD)
Entity Type:Individual
Prefix:DR
First Name:POCHNA
Middle Name:CHOTIKUL
Last Name:KAHLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 OSLER DR
Mailing Address - Street 2:SUITE #305
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7736
Mailing Address - Country:US
Mailing Address - Phone:410-296-9575
Mailing Address - Fax:410-823-4726
Practice Address - Street 1:7505 OSLER DR
Practice Address - Street 2:SUITE #305
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7736
Practice Address - Country:US
Practice Address - Phone:410-296-9575
Practice Address - Fax:410-823-4726
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0014782207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD74341Medicare UPIN
MD4719-PCMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER