Basic Information
| Provider Information | |||||||||
| NPI: | 1346592458 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YADAV | ||||||||
| FirstName: | KUNAL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.B.B.S., M.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4510 DORR ST # MS 840 | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436154040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193833759 | ||||||||
| FaxNumber: | 4193832875 | ||||||||
| Practice Location | |||||||||
| Address1: | 3000 ARLINGTON AVE | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436142595 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193833759 | ||||||||
| FaxNumber: | 4193832875 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2012 | ||||||||
| LastUpdateDate: | 03/15/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 204F00000X | 0101261214 | VA | N | Allopathic & Osteopathic Physicians | Transplant Surgery | 204F00000X | 35.134771 | OH | Y | Allopathic & Osteopathic Physicians | Transplant Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0308267 | 05 | OH | MEDICAID |