Individual
PRADEEP K. KANDULA
Active
Individual
PRADEEP K. KANDULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
19937
WV
208000000X
Pediatrics Physician
Primary
35.073733
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000006496
ANTHEM BCBS
—
01
—
000000181956
UNISON MEDICAID
OH
01
—
001714099
MOUNTAIN STATE BCBS
—
05
—
0111254000
—
WV
01
—
2048108
MOLINA MEDICAID
OH
05
—
2048108
—
OH
01
—
310917085048
CARESOURCE MEDICAID
OH
01
—
370009999
RR MEDICARE
—
Enumeration date
05/20/2006
Last updated
01/21/2021
Update your record
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