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General NPI Number Information
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NPI Number | 1720023021
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Entity Type | Individual
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Provider Name | SITARAM G KADEKAR MD
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Gender | Male
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 10/23/2012
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Provider Practice Location Address
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Address Line | 2050 MEADOWVIEW PARKWAY
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City | KINGSPORT
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State | TN
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Zip | 37660-7332
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Country | US
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Telephone | 423-230-5000
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Fax | 423-230-5097
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Provider Business Mailing Address
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Address Line | 15241 HEATHER MILL LN
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City | HAYMARKET
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State | VA
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Zip | 20169-6220
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Country | US
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Telephone | 571-261-9987
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 39206
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License Number State | TN
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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 | 39206
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207RI0001X
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Taxonomy Name | Clinical & Laboratory Immunology (Internal Medicine) Physician
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License Number | 39206
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License Number State | TN
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