Individual
KEVIN R KANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1040 DELAWARE AVENUE, MARION, OH 43301-1814
(740) 383-8047
(740) 383-7942
Mailing address
L-3549, COLUMBUS, OH 43260-0001
(740) 383-7927
(740) 383-7942
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35.046275
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000118397
ANTHEM
OH
05
—
0457867
—
OH
01
—
0500473
PALMETTO MEDICARE
—
01
—
060018891
TRAVELERS MEDICARE
—
01
—
2500145
UHC
—
01
—
311098079
TAX ID
—
01
—
311098079056
CIGNA
—
01
—
353077
SUBMITTER NO
—
01
—
643330
AETNA
—
Enumeration date
06/09/2006
Last updated
10/08/2014
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