Provider Demographics
NPI:1710933148
Name:KULKARNI, PRADEEP KUMAR (MD)
Entity Type:Individual
Prefix:
First Name:PRADEEP
Middle Name:KUMAR
Last Name:KULKARNI
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 1:952 SETON DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-1950
Mailing Address - Country:US
Mailing Address - Phone:301-724-6787
Mailing Address - Fax:301-724-0701
Practice Address - Street 1:952 SETON DR
Practice Address - Street 2:SUITE 301
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1950
Practice Address - Country:US
Practice Address - Phone:301-724-6787
Practice Address - Fax:301-724-0701
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0036414174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE23690Medicare UPIN
MDKC40Medicare ID - Type Unspecified