Provider Demographics
NPI:1144285016
Name:WADHWA, KAMAL (MD)
Entity type:Individual
Prefix:DR
First Name:KAMAL
Middle Name:
Last Name:WADHWA
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 1:2602 WILMINGTON RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1537
Mailing Address - Country:US
Mailing Address - Phone:724-657-3204
Mailing Address - Fax:724-652-7144
Practice Address - Street 1:2602 WILMINGTON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1537
Practice Address - Country:US
Practice Address - Phone:724-657-3204
Practice Address - Fax:724-652-7144
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD033600L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA006190410004OtherPROMISE NUMBER
PA006190410004OtherPROMISE NUMBER
144619N3CMedicare ID - Type Unspecified