Provider Demographics
NPI:1427008622
Name:KHATRI, JAMIL (MD)
Entity Type:Individual
Prefix:
First Name:JAMIL
Middle Name:
Last Name:KHATRI
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 1:4701 OGLETOWN STANTON RD
Mailing Address - Street 2:SUITE 2400
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2055
Mailing Address - Country:US
Mailing Address - Phone:302-731-7782
Mailing Address - Fax:302-738-5917
Practice Address - Street 1:4701 OGLETOWN STANTON RD
Practice Address - Street 2:SUITE 2400
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2055
Practice Address - Country:US
Practice Address - Phone:302-731-7782
Practice Address - Fax:302-738-5917
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10006241207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD731500701Medicaid
DE0001111201Medicaid
MD006M680EMedicare PIN
DE0001111201Medicaid
PA056089QEGMedicare PIN
G11801Medicare UPIN