Kwatampora, Lily

Kwatampora, Lily is an individual health care provider with primary practice located at 2012 S Main St Ste C, Goshen IN 46526-5200. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Kwatampora, Lily can be contacted via phone (574) 500-2010.

Contact Information

Primary practice address
2012 S Main St Ste C Goshen IN 46526-5200
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X
Other Service Providers / Specialist 174400000X 01076257A Indiana

Profile Details

NPI number 1407182041
LBN Legal business name Kwatampora, Lily
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2009
Last updated May 3rd, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407182041 NPPES
Indiana MEDICAID 201354690

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