Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.122943 | OH |
Y | 2080P0205X | Pediatric Endocrinologist | 35.122943 | OH |
NPI | 1134379670 |
---|---|
Provider Name | Mamatha Kambalapalli |
First Address | Akron, OH 44308-1063 |
Second Address | Akron, OH 44308-1063 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2008 |
Last Update Date | 10/03/2015 |