Provider Demographics
NPI:1891813697
Name:C. S. KADAKIA, M.D. INC.
Entity Type:Organization
Organization Name:C. S. KADAKIA, M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAITANYA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KADAKIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-277-2121
Mailing Address - Street 1:7111 N MAIN ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-2565
Mailing Address - Country:US
Mailing Address - Phone:937-277-2121
Mailing Address - Fax:937-277-2213
Practice Address - Street 1:7111 N MAIN ST
Practice Address - Street 2:SUITE 10
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-2565
Practice Address - Country:US
Practice Address - Phone:937-277-2121
Practice Address - Fax:937-277-2213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-047060207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9298361Medicare ID - Type UnspecifiedGROUP MEDICARE ID