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NPI Code Detail

MEDICARE: SRIPATT KULKAMTHORN M.D.

MEDICARE: SRIPATT KULKAMTHORN M.D.
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 Physician35018MO
2208600000XSurgery Physician35018MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10004000577OTHERMOAETNA
2327602073KULOTHERMOMERCY HEALTH PLAN
33542OTHERMOHEALTHCARE USA PROVIDER #
42365237OTHERMOCIGNA
5115186OTHERMOHEALTHLINK
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
701003230OTHERMOUNITED HEALTHCARE
8431280201OTHERMOAETNA
9A09758OTHERMOCMR
1032901OTHERMOMISSOURI BC/BS
1145992OTHERMOGROUP HEALTH PLAN

General Provider Information

NPI Number : 1306948930
Entity Type Code : Individual
Provider Name (Legal Business Name) : SRIPATT KULKAMTHORN M.D.
Provider Business Mailing Address
First Line : PO BOX 1239
Second Line :
City : TROY
State : MI
Zip : 48099-1239
Country : US
Telephone Number : 248-824-6600
Fax Number : 248-324-1477
Provider Business Practice Location Address
First Line : 8710 MANCHESTER RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63144-2724
Country : US
Telephone Number : 314-961-3570
Fax Number : 314-961-6450
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2006
Last Update Date : 12/07/2011

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