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General NPI Number Information
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NPI Number | 1700503091
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Entity Type | Individual
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Provider Name | KAUSHAL AMRUTLAL UPADHYAY MBBS MD MS
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Gender | Male
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Dates
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Enumeration Date | 10/26/2022
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Last Update Date | 08/04/2024
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Provider Practice Location Address
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Address Line | 705 RILEY HOSPITAL DR RM W6130A
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5109
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Country | US
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Telephone | 253-223-5078
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Fax |
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Provider Business Mailing Address
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Address Line | 705 RILEY HOSPITAL DR RM W6130A
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5109
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Country | US
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Telephone |
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 11023333A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | 36474
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | L6145VP
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License Number State | AL
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