MEDICARE: SUNEEL DEEPAK KAMATH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RX0202X	Medical Oncology Physician	35.135646	OH
2	207R00000X	Internal Medicine Physician	125.062618	IL

General Provider Information

NPI Number	:	1215270343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNEEL DEEPAK KAMATH

Provider Business Mailing Address
First Line	:	441 E ERIE ST APT 5705
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-7155
Country	:	US
Telephone Number	:	513-319-4752
Fax Number	:

Provider Business Practice Location Address
First Line	:	10201 CARNEGIE AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-2130
Country	:	US
Telephone Number	:	866-223-8100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2013
Last Update Date	:	07/12/2019

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