Provider Demographics
NPI:1174617807
Name:KODE, HIMA B (MD)
Entity type:Individual
Prefix:
First Name:HIMA
Middle Name:B
Last Name:KODE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HIMA
Other - Middle Name:B
Other - Last Name:DONNIPUDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10495 MONTGOMERY RD STE 28
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4420
Mailing Address - Country:US
Mailing Address - Phone:513-984-2333
Mailing Address - Fax:513-984-8333
Practice Address - Street 1:10495 MONTGOMERY RD STE 28
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-4420
Practice Address - Country:US
Practice Address - Phone:513-984-2333
Practice Address - Fax:513-984-8333
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0748102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2210717Medicaid
OHG20486Medicare UPIN