Individual
KANDAMURUGU MANICKAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-3538
(614) 722-3546
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-2000
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
35-092399
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2875143
—
OH
01
—
4250173
CGS - MEDICARE
OH
Enumeration date
05/21/2007
Last updated
02/12/2026
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