Provider Demographics
NPI:1871598649
Name:KABADI, MAHESH NARAYAN (MD)
Entity type:Individual
Prefix:DR
First Name:MAHESH
Middle Name:NARAYAN
Last Name:KABADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MAHESH
Other - Middle Name:NARAYAN
Other - Last Name:KABADI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:79 WEBER FARM RD
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-5236
Mailing Address - Country:US
Mailing Address - Phone:860-889-8950
Mailing Address - Fax:860-887-1657
Practice Address - Street 1:12 CASE ST
Practice Address - Street 2:STE 102
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2222
Practice Address - Country:US
Practice Address - Phone:860-889-8950
Practice Address - Fax:860-887-1657
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT026236207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTNLP016OtherOXFORD ID
CT6570931000Medicaid
CT010026236CT01OtherBLUE CROSS BLUE SHIELD ID
CT01026236OtherCIGNA ID
CT262360OtherCONNECTICARE ID
CT262360OtherCONNECTICARE ID
CT6570931000Medicaid
CTAK9055472OtherDEA