Provider Demographics
NPI:1558408914
Name:KHALSA, MIRIAM ATMA (CPM)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:ATMA
Last Name:KHALSA
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:SHERBORN
Mailing Address - State:MA
Mailing Address - Zip Code:01770-1615
Mailing Address - Country:US
Mailing Address - Phone:508-655-7885
Mailing Address - Fax:
Practice Address - Street 1:169 FOREST ST
Practice Address - Street 2:
Practice Address - City:SHERBORN
Practice Address - State:MA
Practice Address - Zip Code:01770-1615
Practice Address - Country:US
Practice Address - Phone:508-655-7885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife