Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 04-36668 | KS |
N | 207X00000X | Orthopaedic Surgeon | MD-42289 | IA |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 125.059018 | IL |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | MT202820 | PA |
NPI | 1326327149 |
---|---|
Provider Name | Dr. Yogesh Vinod Kolwadkar |
First Address | Spencer, IA 51301-3901 |
Second Address | Spencer, IA 51301-3901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2011 |
Last Update Date | 02/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I113010004 | MEDICARE (01) | IA |