Provider Demographics
NPI:1235366634
Name:KOLAPPA, KAMAL KUMAR PADMANABHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMAL
Middle Name:KUMAR PADMANABHAN
Last Name:KOLAPPA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:116 BRUSHY LAKE WAY
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-4841
Mailing Address - Country:US
Mailing Address - Phone:919-451-2641
Mailing Address - Fax:
Practice Address - Street 1:7560 CARPENTER FIRE STATION RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-8616
Practice Address - Country:US
Practice Address - Phone:919-451-2641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC157356390200000X
NC2015-01-443207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1235366634Medicaid