Individual
DR. AJAY K KANDRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1373 E STATE ROAD 62, MADISON, IN 47250-7328
(812) 801-0603
(812) 801-0589
Mailing address
PO BOX 447, MADISON, IN 47250-0447
(812) 801-0603
(812) 801-0589
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD433349
PA
207RH0003X
Hematology & Oncology Physician
01070122A
IN
207RH0003X
Hematology & Oncology Physician
Primary
49834
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201037340
—
IN
01
—
412840138
MEDICARE
IN
05
—
7100457230
—
KY
Enumeration date
02/01/2008
Last updated
07/21/2023
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