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Individual

SUSEELAMM R KANDULA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3130 N COUNTY ROAD 25A, TROY, OH 45373-1337
(937) 440-4000
(937) 440-7882
Mailing address
3130 N COUNTY ROAD 25A, TROY, OH 45373-1337
(937) 440-4000
(937) 440-7882

Taxonomy

Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
35-040791-K
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0526550
OH
Enumeration date
11/14/2006
Last updated
11/20/2007
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