Provider Demographics
NPI:1346592458
Name:YADAV, KUNAL (MBBS, MS)
Entity Type:Individual
Prefix:DR
First Name:KUNAL
Middle Name:
Last Name:YADAV
Suffix:
Gender:M
Credentials:MBBS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 DORR ST # MS 840
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-4040
Mailing Address - Country:US
Mailing Address - Phone:419-383-3759
Mailing Address - Fax:419-383-2875
Practice Address - Street 1:3000 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2595
Practice Address - Country:US
Practice Address - Phone:419-383-3759
Practice Address - Fax:419-383-2875
Is Sole Proprietor?:No
Enumeration Date:2012-10-12
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101261214204F00000X, 204F00000X
OH35.134771204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0308267Medicaid