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NPI Code Detail

MEDICARE: SOMASUNDERAM PADMALINGAM MD

MEDICARE: SOMASUNDERAM PADMALINGAM MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianC10001554DE
2207Q00000XFamily Medicine Physician01077156AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306944228
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOMASUNDERAM PADMALINGAM MD
Provider Business Mailing Address
First Line : 14315 BRIDGESTONE RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46814-9144
Country : US
Telephone Number : 302-584-6067
Fax Number :
Provider Business Practice Location Address
First Line : 3910 LIMA RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-1031
Country : US
Telephone Number : 260-420-6040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 05/07/2021

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Directions to “ SOMASUNDERAM PADMALINGAM MD” Practice Location

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