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General NPI Number Information
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NPI Number | 1487648069
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Entity Type | Individual
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Provider Name | RADHIKA PRASAD KAKARLA MD
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Gender | Female
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Dates
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Enumeration Date | 09/09/2005
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Last Update Date | 01/15/2014
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Provider Practice Location Address
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Address Line | 85 OLD EAGLE SCHOOL RD 101
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City | STRAFFORD
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State | PA
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Zip | 19087-2544
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Country | US
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Telephone | 610-971-9461
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Fax | 610-688-4490
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Provider Business Mailing Address
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Address Line | 85 OLD EAGLE SCHOOL RD
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City | STRAFFORD
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State | PA
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Zip | 19087-2544
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Country | US
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Telephone | 610-971-9461
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Fax | 610-688-4490
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | L1902
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD428592
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License Number State | PA
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