Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 05-38108 | KS |
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 2015017623 | MO |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 20A13450 | CA |
NPI | 1023265667 |
---|---|
Provider Name | Sathya Vadivelu |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64108-4619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2008 |
Last Update Date | 01/09/2015 |