Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.124064 | OH |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 01078042A | IN |
NPI | 1134410541 |
---|---|
Provider Name | Suyog J Kamatkar |
First Address | Indianapolis, IN 46250-2890 |
Second Address | Indianapolis, IN 46256-1695 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2011 |
Last Update Date | 28/09/2020 |