Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 01074176A | IN |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 125.053464 | IL |
NPI | 1073724076 |
---|---|
Provider Name | Kedar Arvind Kakodkar |
First Address | Munster, IN 46321-3958 |
Second Address | Munster, IN 46321-3958 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 19/08/2020 |