Individual
AMY KAKKANATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301097290
MI
2080P0205X
Pediatric Endocrinology Physician
Primary
0101264932
VA
Other
Enumeration date
07/14/2010
Last updated
01/11/2024
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