Provider Demographics
NPI:1285601765
Name:KULKARNI, ANUPAMA S (MD)
Entity type:Individual
Prefix:
First Name:ANUPAMA
Middle Name:S
Last Name:KULKARNI
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 1:450 N HYATT ST
Mailing Address - Street 2:202
Mailing Address - City:TIPP CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45371
Mailing Address - Country:US
Mailing Address - Phone:937-669-3707
Mailing Address - Fax:937-669-1266
Practice Address - Street 1:450 N HYATT ST
Practice Address - Street 2:202
Practice Address - City:TIPP CITY
Practice Address - State:OH
Practice Address - Zip Code:45371
Practice Address - Country:US
Practice Address - Phone:937-669-3707
Practice Address - Fax:937-669-1266
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35069163207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0230360Medicaid
G23413Medicare UPIN
OH0846912Medicare ID - Type Unspecified