Ghosh, Amita
Ghosh, Amita is an individual health care provider with primary practice located at 1106 4Th Ave , Moline IL 61265. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Ghosh, Amita can be contacted via phone (563) 336-3000.Contact Information
Primary practice address
1106 4Th Ave
Moline IL 61265
Phone: (563) 336-3000
Fax: (563) 327-2045
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036145083 | Illinois |
Profile Details
| NPI number | 1376925289 |
|---|---|
| LBN Legal business name | Ghosh, Amita |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2015 |
| Last updated | Jul 24th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376925289 | NPPES |
| Illinois | MEDICAID | 036145083 | |
| Illinois | MEDICAID | 1376925289 |
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