Provider Demographics
NPI:1750311478
Name:KULKARNI, UPENDRA M (MD)
Entity Type:Individual
Prefix:DR
First Name:UPENDRA
Middle Name:M
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 1:805 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:MAMOU
Mailing Address - State:LA
Mailing Address - Zip Code:70554-2223
Mailing Address - Country:US
Mailing Address - Phone:337-468-2250
Mailing Address - Fax:337-468-2702
Practice Address - Street 1:805 CHERRY ST
Practice Address - Street 2:
Practice Address - City:MAMOU
Practice Address - State:LA
Practice Address - Zip Code:70554-2223
Practice Address - Country:US
Practice Address - Phone:337-468-2250
Practice Address - Fax:337-468-2702
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA05120R207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1303020Medicaid
LAB64617Medicare UPIN
LA53433Medicare ID - Type Unspecified