Provider Demographics
NPI:1316947708
Name:UMAPATHY, KANDASAMY (MD)
Entity type:Individual
Prefix:
First Name:KANDASAMY
Middle Name:
Last Name:UMAPATHY
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 1:88 CENTER RD STE 350
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-2775
Mailing Address - Country:US
Mailing Address - Phone:440-439-7766
Mailing Address - Fax:
Practice Address - Street 1:88 CENTER RD STE 350
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-2775
Practice Address - Country:US
Practice Address - Phone:440-439-7766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074954207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2115179Medicaid
OHG93485Medicare UPIN
OH2115179Medicaid