Healthcare Provider Details

I. General information

NPI: 1255688461
Provider Name (Legal Business Name): SWETHA L NARAYANA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SWETHA NANDANAVANA SUBBAREDDY

II. Dates (important events)

Enumeration Date: 08/07/2012
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 W SHARON RD
CINCINNATI OH
45246-4137
US

IV. Provider business mailing address

212 W SHARON RD
CINCINNATI OH
45246-4137
US

V. Phone/Fax

Practice location:
  • Phone: 513-771-7213
  • Fax: 513-771-4356
Mailing address:
  • Phone: 513-771-7213
  • Fax: 513-771-4356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMT201901
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberMD 42640
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-42640
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: