Provider Demographics
NPI:1023635646
Name:KABADI, SUSHILA LYNN (DPM)
Entity type:Individual
Prefix:
First Name:SUSHILA
Middle Name:LYNN
Last Name:KABADI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 W MONROE ST
Mailing Address - Street 2:
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-2240
Mailing Address - Country:US
Mailing Address - Phone:276-228-2212
Mailing Address - Fax:276-228-7835
Practice Address - Street 1:5270 ALEXANDER RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:VA
Practice Address - Zip Code:24084-3650
Practice Address - Country:US
Practice Address - Phone:540-674-2444
Practice Address - Fax:540-674-2462
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103301404213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery