Basic Information
Provider Information
NPI: 1114145307
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KHOV
FirstName: STEVEN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 540 N DUKE ST
Address2: STE 244
City: LANCASTER
State: PA
PostalCode: 176022374
CountryCode: US
TelephoneNumber: 7178269781
FaxNumber: 7179455177
Practice Location
Address1: 540 N DUKE ST
Address2: STE 244
City: LANCASTER
State: PA
PostalCode: 176022374
CountryCode: US
TelephoneNumber: 7178269770
FaxNumber: 7179455177
Other Information
ProviderEnumerationDate: 04/23/2007
LastUpdateDate: 04/22/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XOT012009PAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0200XOS015401PAN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
208000000XOT012009PAN Allopathic & Osteopathic PhysiciansPediatrics 
207RP1001XOS015401PAY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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