Provider Demographics
NPI:1992092886
Name:KADAKIA, DEVI S (PA-C)
Entity type:Individual
Prefix:MRS
First Name:DEVI
Middle Name:S
Last Name:KADAKIA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:DEVI
Other - Middle Name:V
Other - Last Name:DESAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:30 E APPLE ST STE 5253
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2939
Mailing Address - Country:US
Mailing Address - Phone:937-208-5439
Mailing Address - Fax:
Practice Address - Street 1:30 E APPLE ST STE 5253
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409
Practice Address - Country:US
Practice Address - Phone:937-208-5439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017237-1363AS0400X
MDC0004467363AS0400X
OH50.005791RX363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical