Individual
VIDULA KHADILKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3100 E 45TH ST, SUITE 504, CLEVELAND, OH 44127-1088
(216) 429-0077
Mailing address
412 QUAIL RUN DR, BROADVIEW HEIGHTS, OH 44147-3407
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35068226K
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2451921
—
OH
01
—
942460636103
CARESOURCE
OH
Enumeration date
05/28/2006
Last updated
11/10/2016
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