Healthcare Provider Details

I. General information

NPI: 1831452051
Provider Name (Legal Business Name): SAGAR KADAKIA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 WALNUT ST FL 5 SUITE 1003
PHILADELPHIA PA
19107-4944
US

IV. Provider business mailing address

1015 WALNUT ST STE 620 SUITE 1003
PHILADELPHIA PA
19107-5005
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-6750
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number24851
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD461953
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: