MEDICARE: SANJEEVANI TAKEMALKER KULKARNI 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	DO27265	MD

General Provider Information

NPI Number	:	1922043561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANJEEVANI TAKEMALKER KULKARNI MD

Provider Business Mailing Address
First Line	:	PO BOX 856
Second Line	:	1020 EDGEWOOD RD
City	:	EDGEWOOD
State	:	MD
Zip	:	21040-0856
Country	:	US
Telephone Number	:	410-679-5755
Fax Number	:	410-679-6613

Provider Business Practice Location Address
First Line	:	1020 EDGEWOOD RD
Second Line	:
City	:	EDGEWOOD
State	:	MD
Zip	:	21040
Country	:	US
Telephone Number	:	410-679-5755
Fax Number	:	410-679-6613

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

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	07/08/2007

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