Basic Information
Provider Information
NPI: 1699856823
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KALRA
FirstName: MANINDER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 700 CHILDRENS DR
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432052664
CountryCode: US
TelephoneNumber: 6147222000
FaxNumber: 6147224755
Practice Location
Address1: 700 CHILDRENS DR
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432052664
CountryCode: US
TelephoneNumber: 6147222000
FaxNumber: 6147224755
Other Information
ProviderEnumerationDate: 10/17/2006
LastUpdateDate: 09/06/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/06/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X35078485OHN Allopathic & Osteopathic PhysiciansPediatrics 
2080P0214X35.078485OHN Allopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
2080S0012X35078485OHY Allopathic & Osteopathic PhysiciansPediatricsSleep Medicine

ID Information
IDTypeStateIssuerDescription
228925005OH MEDICAID


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