Provider Demographics
NPI:1205806056
Name:DAVE, NIKHIL K (MD)
Entity type:Individual
Prefix:DR
First Name:NIKHIL
Middle Name:K
Last Name:DAVE
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 1:1200 MCKEAN AVE
Mailing Address - Street 2:103
Mailing Address - City:CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-2141
Mailing Address - Country:US
Mailing Address - Phone:724-483-2060
Mailing Address - Fax:
Practice Address - Street 1:1200 MCKEAN AVE
Practice Address - Street 2:103
Practice Address - City:CHARLEROI
Practice Address - State:PA
Practice Address - Zip Code:15022-2141
Practice Address - Country:US
Practice Address - Phone:724-483-2060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 043368-L207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAD78056Medicare UPIN