Provider Demographics
NPI:1750344503
Name:KULKARNI, PRADEEP K (MD)
Entity type:Individual
Prefix:
First Name:PRADEEP
Middle Name:K
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:PO BOX 384
Mailing Address - Street 2:
Mailing Address - City:WINDBER
Mailing Address - State:PA
Mailing Address - Zip Code:15963-0384
Mailing Address - Country:US
Mailing Address - Phone:814-467-3176
Mailing Address - Fax:814-467-3177
Practice Address - Street 1:600 SOMERSET AVE
Practice Address - Street 2:
Practice Address - City:WINDBER
Practice Address - State:PA
Practice Address - Zip Code:15963-1331
Practice Address - Country:US
Practice Address - Phone:814-467-3176
Practice Address - Fax:814-467-3177
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036686L207V00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA010783880Medicaid
PA024836OtherHIGHMARK
PAB33509Medicare UPIN
PA024836Medicare ID - Type Unspecified