Provider Demographics
NPI:1437143773
Name:KAUL, KAMLESH (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMLESH
Middle Name:
Last Name:KAUL
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:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:915 SAGAMORE PKWY W
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-1443
Practice Address - Country:US
Practice Address - Phone:765-463-2424
Practice Address - Fax:765-463-2249
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01054667A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00668323OtherRR MEDICARE
IN000000623476OtherANTHEM PROVIDER NUMBER
IN113732OtherANTHEM MEDICAID
IN200341200Medicaid
IN000000588206OtherANTHEM
IN1267659OtherCIGNA
IN000000604157OtherANTHEM
IN000000623476OtherANTHEM PROVIDER NUMBER
IN1267659OtherCIGNA
IN000000604157OtherANTHEM
IN252000OMedicare PIN
IN200341200Medicaid
IN815500BB1Medicare PIN