Individual
DEEPA PRASAD KUDALKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
379 DIXMYTH AVE, CINCINNATI, OH 45220-2475
(513) 246-7016
(513) 852-3283
Mailing address
379 DIXMYTH AVE, CINCINNATI, OH 45220-2475
(513) 246-7016
(513) 852-3283
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
11197
NV
207RR0500X
Rheumatology Physician
Primary
35-092770
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2980181
MEDICAID
OH
01
—
699435
BUCKEYE - MEDICARE
OH
01
—
7100287660
MEDICAID
KY
01
—
737691
ANTHEM
OH
01
—
760174
BUCKEYE - MEDICAID
OH
01
—
7708721
AETNA
OH
01
—
H110400
MEDICARE
OH
01
—
P01107611
RAILROAD MEDICARE
OH
Enumeration date
07/07/2005
Last updated
10/30/2024
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