Healthcare Provider Details

I. General information

NPI: 1780904425
Provider Name (Legal Business Name): VINAYAK A HEGDE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2010
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 W EXCHANGE ST #305
AKRON OH
44302-1704
US

IV. Provider business mailing address

224 W EXCHANGE ST #305
AKRON OH
44302-1704
US

V. Phone/Fax

Practice location:
  • Phone: 330-344-7400
  • Fax: 330-344-2015
Mailing address:
  • Phone: 330-344-7400
  • Fax: 330-344-2015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35-095466
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: