Individual
VENKATA GANGADHAR TILAK KADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6500 HOSPITAL DR, HANNIBAL, MO 63401-6890
(573) 629-3400
(573) 629-3414
Mailing address
PO BOX 1239, 6500 HOSPITAL DRIVE, HANNIBAL, MO 63401-1239
(573) 629-3400
(573) 629-3414
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101256401
VA
207Q00000X
Family Medicine Physician
Primary
2013023689
MO
207QG0300X
Geriatric Medicine (Family Medicine) Physician
0101256401
VA
390200000X
Student in an Organized Health Care Education/Training Program
125053634
IL
Other
Enumeration date
08/06/2007
Last updated
08/23/2016
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