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NPI Code Detail

MEDICARE: USHA V KANAKAMEDALA MD

MEDICARE: USHA V KANAKAMEDALA 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
12085R0202XDiagnostic Radiology PhysicianMD061561LPA

General Provider Information

NPI Number : 1801840236
Entity Type Code : Individual
Provider Name (Legal Business Name) : USHA V KANAKAMEDALA MD
Provider Business Mailing Address
First Line : 100 N ACADEMY AVE
Second Line :
City : DANVILLE
State : PA
Zip : 17822-4903
Country : US
Telephone Number : 570-271-6144
Fax Number :
Provider Business Practice Location Address
First Line : 132 ABIGAIL LANE
Second Line :
City : PORT MATILDA
State : PA
Zip : 16870-5700
Country : US
Telephone Number : 814-272-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2006
Last Update Date : 07/21/2022

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