MEDICARE: C. S. KADAKIA, M.D. INC.

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	207R00000X	Internal Medicine Physician	35-047060	OH

General Provider Information

NPI Number	:	1891813697
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C. S. KADAKIA, M.D. INC.

Provider Business Mailing Address
First Line	:	7111 N MAIN ST
Second Line	:	SUITE 10
City	:	DAYTON
State	:	OH
Zip	:	45415-2565
Country	:	US
Telephone Number	:	937-277-2121
Fax Number	:	937-277-2213

Provider Business Practice Location Address
First Line	:	7111 N MAIN ST
Second Line	:	SUITE 10
City	:	DAYTON
State	:	OH
Zip	:	45415-2565
Country	:	US
Telephone Number	:	937-277-2121
Fax Number	:	937-277-2213

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHAITANYA S KADAKIA
Credential	:	M.D.
Telephone Number	:	937-277-2121

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	08/22/2020

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