MEDICARE: RAVINDHAR VODELA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	036124797	IL
2	207RI0200X	Infectious Disease Physician	35.123439	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588720023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAVINDHAR VODELA MD

Provider Business Mailing Address
First Line	:	3301 MERCY HEALTH BLVD
Second Line	:	SUITE 300
City	:	CINCINNATI
State	:	OH
Zip	:	45211-1105
Country	:	US
Telephone Number	:	513-686-5950
Fax Number	:	513-686-5620

Provider Business Practice Location Address
First Line	:	3301 MERCY HEALTH BLVD
Second Line	:	SUITE 300
City	:	CINCINNATI
State	:	OH
Zip	:	45211-1105
Country	:	US
Telephone Number	:	513-686-5950
Fax Number	:	513-686-5620

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	02/03/2015

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Directions to “ RAVINDHAR VODELA MD” Practice Location

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