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Individual

DR. SITARAM G KADEKAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2050 MEADOWVIEW PARKWAY, KINGSPORT, TN 37660-7332
(423) 230-5000
(423) 230-5097
Mailing address
15241 HEATHER MILL LN, HAYMARKET, VA 20169-6220
(571) 261-9987

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
39206
TN
207RC0000X
Cardiovascular Disease Physician
Primary
39206
TN
207RI0001X
Clinical & Laboratory Immunology (Internal Medicine) Physician
39206
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00217007
TN
05
010150647
VA
05
3327537
TN
01
621112685
UNITED HEALTHCARE
TN
05
64110778
KY
Enumeration date
06/19/2006
Last updated
10/23/2012
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