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NPI Code Detail

MEDICARE: VIJAY KAKUMANU MD LLC

MEDICARE: VIJAY KAKUMANU MD LLC
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
1207R00000XInternal Medicine Physician

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 : 1780229435
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIJAY KAKUMANU MD LLC
Provider Business Mailing Address
First Line : 4036 CENTER RD UNIT B
Second Line :
City : BRUNSWICK
State : OH
Zip : 44212-2945
Country : US
Telephone Number : 330-225-7733
Fax Number :
Provider Business Practice Location Address
First Line : 4036 CENTER RD UNIT B
Second Line :
City : BRUNSWICK
State : OH
Zip : 44212-2945
Country : US
Telephone Number : 330-225-7733
Fax Number : 330-220-0902
Authorized Official
Title or Position : CEO
Name : DR. VIJAY KAKUMANU
Credential : MD
Telephone Number : 440-371-4024
Provider Enumeration Date : 11/16/2019
Last Update Date : 07/17/2025

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Directions to “VIJAY KAKUMANU MD LLC ” Practice Location

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