Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MT036319 | PA |
N | 111NI0900X | Internist | MT036319 | PA |
NPI | 1003064395 |
---|---|
Provider Name | Dr. Kaustubh Subhash Yadwadkar |
First Address | Washington, DC 20007-2113 |
Second Address | Washington, DC 20007-2113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2008 |
Last Update Date | 09/10/2014 |