Provider Demographics
NPI:1366405854
Name:LINGAM, KALYAN SAI (MD)
Entity type:Individual
Prefix:DR
First Name:KALYAN
Middle Name:SAI
Last Name:LINGAM
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 1:6397 EMERALD PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-2200
Mailing Address - Country:US
Mailing Address - Phone:614-777-5860
Mailing Address - Fax:614-777-5777
Practice Address - Street 1:6397 EMERALD PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-2200
Practice Address - Country:US
Practice Address - Phone:614-777-5860
Practice Address - Fax:614-777-5777
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35085686207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2594303Medicaid
OH2594303Medicaid
4161111Medicare ID - Type Unspecified