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General NPI Number Information
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NPI Number | 1265515662
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Entity Type | Individual
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Provider Name | JAGDESH KANDALA MD
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 09/14/2025
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Provider Practice Location Address
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Address Line | 400 MATTHEW ST STE 302
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City | MARIETTA
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State | OH
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Zip | 45750-1656
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Country | US
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Telephone | 740-568-5207
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Fax | 740-568-5297
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Provider Business Mailing Address
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Address Line | 9500 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 800-223-2273
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Fax | 800-223-2273
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 35.144262
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 35.144262
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 290180
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License Number State | NY
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