Provider Demographics
NPI:1285749051
Name:DABHI, KISHOR S (MD)
Entity type:Individual
Prefix:
First Name:KISHOR
Middle Name:S
Last Name:DABHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3628 BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-1342
Mailing Address - Country:US
Mailing Address - Phone:804-526-5850
Mailing Address - Fax:804-520-7312
Practice Address - Street 1:3628 BOULEVARD
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-1342
Practice Address - Country:US
Practice Address - Phone:804-526-5850
Practice Address - Fax:804-520-7312
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2021-09-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101057702207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5860857Medicaid
VA5860857Medicaid