MEDICARE: SHIVKAMINI SOMASUNDARAM 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
1	207V00000X	Obstetrics & Gynecology Physician	35079744	OH

General Provider Information

NPI Number	:	1760437982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIVKAMINI SOMASUNDARAM MD

Provider Business Mailing Address
First Line	:	5450 FRANTZ RD STE 360
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43016-4141
Country	:	US
Telephone Number	:	614-544-6155
Fax Number	:	614-544-6370

Provider Business Practice Location Address
First Line	:	3600 CLEVELAND AVE STE A
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-2910
Country	:	US
Telephone Number	:	614-583-5552
Fax Number	:	614-583-5559

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	01/05/2022

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