Provider Demographics
NPI:1043323827
Name:NEELKANTAN, KAMAKSHI (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMAKSHI
Middle Name:
Last Name:NEELKANTAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KAMAKSHI
Other - Middle Name:
Other - Last Name:NEELKANTAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1466
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21922-1466
Mailing Address - Country:US
Mailing Address - Phone:410-398-0590
Mailing Address - Fax:443-681-7671
Practice Address - Street 1:101 CHESAPEAKE BLVD STE B
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-6607
Practice Address - Country:US
Practice Address - Phone:410-398-0590
Practice Address - Fax:443-681-7671
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD24744208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics