Provider Demographics
NPI:1477569176
Name:KADAKOL, SAVITHA (MD)
Entity Type:Individual
Prefix:
First Name:SAVITHA
Middle Name:
Last Name:KADAKOL
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 1:8244 METROPOLITAN PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-2778
Mailing Address - Country:US
Mailing Address - Phone:586-795-4060
Mailing Address - Fax:
Practice Address - Street 1:8244 METROPOLITAN PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-2778
Practice Address - Country:US
Practice Address - Phone:586-795-4060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301091736207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI383834241OtherTAX ID
MI1477569176Medicaid
MI1205126430OtherCORPORATE NPI
MI4301091736OtherLICENSE
MI700H217350OtherMI BLUE SHIELD
MI383834241OtherTAX ID
MI0M92440Medicare PIN