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General NPI Number Information
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NPI Number | 1538347521
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Entity Type | Individual
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Provider Name | AJAY K KANDRA MD
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Gender | Male
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Dates
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Enumeration Date | 02/01/2008
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Last Update Date | 07/21/2023
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Provider Practice Location Address
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Address Line | 1373 E STATE ROAD 62
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City | MADISON
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State | IN
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Zip | 47250-7328
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Country | US
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Telephone | 812-801-0603
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Fax | 812-801-0589
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Provider Business Mailing Address
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Address Line | PO BOX 447
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City | MADISON
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State | IN
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Zip | 47250-0447
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Country | US
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Telephone | 812-801-0603
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Fax | 812-801-0589
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 01070122A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD433349
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 49834
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License Number State | KY
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