Provider Demographics
NPI:1821102237
Name:KHER, KINNARI RAHUL (MD)
Entity Type:Individual
Prefix:DR
First Name:KINNARI
Middle Name:RAHUL
Last Name:KHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KINNARI
Other - Middle Name:HARISH
Other - Last Name:WORAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:20 HOLLAND ST
Mailing Address - Street 2:SUITE 407
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2700
Mailing Address - Country:US
Mailing Address - Phone:617-625-4888
Mailing Address - Fax:617-776-1175
Practice Address - Street 1:20 HOLLAND ST
Practice Address - Street 2:SUITE 407
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2700
Practice Address - Country:US
Practice Address - Phone:617-625-4888
Practice Address - Fax:617-776-1175
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA208523207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2093944Medicaid
MAKHA37747Medicare ID - Type Unspecified