Provider Demographics
NPI:1134312549
Name:POSAVANIKE KAILASNATH, VASUNDHARA (MD)
Entity Type:Individual
Prefix:DR
First Name:VASUNDHARA
Middle Name:
Last Name:POSAVANIKE KAILASNATH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:STEAD FAMILY DEPARTMENT OF PEDIATRICS
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-384-5966
Mailing Address - Fax:319-353-7790
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:STEAD FAMILY DEPARTMENT OF PEDIATRICS
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-384-5966
Practice Address - Fax:319-353-7790
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-423112080P0207X
FLME114269208000000X
IAMD42311208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009567500Medicaid