Provider Demographics
NPI:1700864626
Name:ADDO, KAMEL (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMEL
Middle Name:
Last Name:ADDO
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 951144
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0005
Mailing Address - Country:US
Mailing Address - Phone:614-546-4400
Mailing Address - Fax:
Practice Address - Street 1:745 MOUNT CARMEL MALL
Practice Address - Street 2:SUITE 750
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43222-1543
Practice Address - Country:US
Practice Address - Phone:614-224-2281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD11414207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4297041Medicare PIN
RI007056954Medicare ID - Type Unspecified