Provider Demographics
NPI:1942683958
Name:TODKAR, SUPRIYA (MD)
Entity Type:Individual
Prefix:
First Name:SUPRIYA
Middle Name:
Last Name:TODKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4760 E GALBRAITH RD STE 212
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-6704
Mailing Address - Country:US
Mailing Address - Phone:513-686-2663
Mailing Address - Fax:513-686-3637
Practice Address - Street 1:4760 E GALBRAITH RD STE 212
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-6704
Practice Address - Country:US
Practice Address - Phone:513-686-2663
Practice Address - Fax:513-686-3637
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301107773390200000X
OH35.149572207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program