MEDICARE: DR. KAMLESH KAUL 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
1	207Q00000X	Family Medicine Physician	01054667A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00668323	OTHER	IN	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	000000623476	OTHER	IN	ANTHEM PROVIDER NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	000000588206	OTHER	IN	ANTHEM
6	1267659	OTHER	IN	CIGNA
7	000000604157	OTHER	IN	ANTHEM

General Provider Information

NPI Number	:	1437143773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAMLESH KAUL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 781076
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48278-1076
Country	:	US
Telephone Number	:	317-528-4800
Fax Number	:	317-865-1479

Provider Business Practice Location Address
First Line	:	915 SAGAMORE PKWY W
Second Line	:
City	:	WEST LAFAYETTE
State	:	IN
Zip	:	47906-1443
Country	:	US
Telephone Number	:	765-463-2424
Fax Number	:	765-463-2249

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	05/05/2023

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