Healthcare Provider Details

I. General information

NPI: 1366405854
Provider Name (Legal Business Name): KALYAN SAI LINGAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 09/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6397 EMERALD PKWY SUITE 100
DUBLIN OH
43016-2200
US

IV. Provider business mailing address

6397 EMERALD PKWY SUITE 100
DUBLIN OH
43016-2200
US

V. Phone/Fax

Practice location:
  • Phone: 614-777-5860
  • Fax: 614-777-5777
Mailing address:
  • Phone: 614-777-5860
  • Fax: 614-777-5777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number35085686
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: