Provider Demographics
NPI:1407979230
Name:KADIM, SATYANARAYANA VENKATA (MD)
Entity Type:Individual
Prefix:DR
First Name:SATYANARAYANA
Middle Name:VENKATA
Last Name:KADIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-1506
Mailing Address - Country:US
Mailing Address - Phone:740-533-9002
Mailing Address - Fax:740-533-9002
Practice Address - Street 1:411 CENTER ST
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-1506
Practice Address - Country:US
Practice Address - Phone:740-533-9002
Practice Address - Fax:740-533-9002
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-6461K207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0499894Medicaid
OHD31299Medicare UPIN
OHKA0519362Medicare ID - Type Unspecified