Provider Demographics
NPI:1730466640
Name:KAMMULA, UDAI S (MD)
Entity Type:Individual
Prefix:DR
First Name:UDAI
Middle Name:S
Last Name:KAMMULA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6514 DEMOCRACY BLVD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1679
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5150 CENTRE AVE STE 414
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1309
Practice Address - Country:US
Practice Address - Phone:412-623-4861
Practice Address - Fax:412-692-2520
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-05
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2241962086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology