Kandallu, Kannan

Kandallu, Kannan is an individual health care provider with primary practice located at 5454 Hohman Ave , Hammond IN 46320-1931. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Kandallu, Kannan can be contacted via phone (219) 933-2006.

Contact Information

Primary practice address
5454 Hohman Ave Hammond IN 46320-1931
Phone: (219) 933-2006
Fax: (219) 738-6714
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 01046704 Indiana
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 01046704 Indiana

Profile Details

NPI number 1740279082
LBN Legal business name Kandallu, Kannan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2005
Last updated Jan 25th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740279082 NPPES
Indiana MEDICAID 200157240

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