Provider Demographics
NPI:1427724020
Name:KODE, UDAY GANESH
Entity type:Individual
Prefix:
First Name:UDAY
Middle Name:GANESH
Last Name:KODE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 KEDZIE ST
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-4533
Mailing Address - Country:US
Mailing Address - Phone:248-326-4767
Mailing Address - Fax:
Practice Address - Street 1:405 W GREENLAWN AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-2898
Practice Address - Country:US
Practice Address - Phone:248-621-4792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist