Basic Information
Provider Information
NPI: 1396908331
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KADAMBI
FirstName: NAVIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 804 SCOTT NIXON MEMORIAL DR
Address2:  
City: AUGUSTA
State: GA
PostalCode: 30907
CountryCode: US
TelephoneNumber: 7066500705
FaxNumber: 7066501034
Practice Location
Address1: 1500 FOREST GLEN RD
Address2:  
City: SILVER SPRINGS
State: MD
PostalCode: 20910
CountryCode: US
TelephoneNumber: 3019428799
FaxNumber: 3019338554
Other Information
ProviderEnumerationDate: 07/09/2008
LastUpdateDate: 07/10/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XD67836MDY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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