Provider Demographics
NPI:1336229459
Name:DOGHRAMJI, KARL (MD)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:
Last Name:DOGHRAMJI
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 1:211 S 9TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-6810
Mailing Address - Country:US
Mailing Address - Phone:215-955-6175
Mailing Address - Fax:215-955-9783
Practice Address - Street 1:211 S 9TH ST
Practice Address - Street 2:SUITE 500
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-6810
Practice Address - Country:US
Practice Address - Phone:215-955-6175
Practice Address - Fax:215-955-9783
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025521E2084P0800X, 2084S0012X
NJ25MA097693002084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
0056292000OtherKEYSTONE HEALTH PLAN EAST
PA067511OtherHIGHMARK BLUESHIELD
PA0970031Medicaid
B34794Medicare UPIN
B34794Medicare UPIN