Provider Demographics
NPI:1265537773
Name:DOSHI, ILA H (MD)
Entity type:Individual
Prefix:DR
First Name:ILA
Middle Name:H
Last Name:DOSHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:717 S BLACK HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2811
Mailing Address - Country:US
Mailing Address - Phone:856-227-2020
Mailing Address - Fax:856-227-2646
Practice Address - Street 1:717 S BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:BLACKWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08012-2811
Practice Address - Country:US
Practice Address - Phone:856-227-2020
Practice Address - Fax:856-227-2646
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA03803000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC53730Medicare UPIN