Healthcare Provider Details

I. General information

NPI: 1811998925
Provider Name (Legal Business Name): ARUN RAJGURU KADAMBI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 06/08/2022
Certification Date: 06/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1136 MONARCH ST.
LEXINGTON KY
40515
US

IV. Provider business mailing address

1136 MONARCH ST.
LEXINGTON KY
40513
US

V. Phone/Fax

Practice location:
  • Phone: 859-223-0000
  • Fax: 859-223-0602
Mailing address:
  • Phone: 859-223-0000
  • Fax: 859-223-0602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number34760
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: