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NPI Code Detail

MEDICARE: PAVITHRA M. INDRAMOHAN MD

MEDICARE: PAVITHRA M. INDRAMOHAN 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
1207RG0300XGeriatric Medicine (Internal Medicine) Physician35C.003321OH

General Provider Information

NPI Number : 1659713584
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAVITHRA M. INDRAMOHAN MD
Provider Business Mailing Address
First Line : 1249 15TH ST STE 4093
Second Line :
City : HUNTINGTON
State : WV
Zip : 25701-3662
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-445-4415
Fax Number : 216-445-8762
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2013
Last Update Date : 01/13/2026

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