Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 35089286 | OH |
NPI | 1013094382 |
---|---|
Provider Name | Dr. Prasad R Kudalkar |
First Address | Cincinnati, OH 45226-2326 |
Second Address | Fairfield, OH 45014-5376 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 19/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201041210 | (05) | IN |
2762685 | (05) | OH |
7100178540 | (05) | KY |
I27101 | (02) |