Individual
KANDASAMY AMBALAVANAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
85 KINDRED WAY APT 203, GLEN BURNIE, MD 21061-5249
(410) 766-6447
(410) 766-9780
Mailing address
85 KINDRED WAY APT 203, GLEN BURNIE, MD 21061-5249
(410) 766-6447
(410) 766-9780
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0051596
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147400600
—
MD
Enumeration date
10/03/2006
Last updated
01/06/2026
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