Healthcare Provider Details

I. General information

NPI: 1730684689
Provider Name (Legal Business Name): SRICHANDHANA RAJAMOULI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2018
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7545 BEECHMONT AVE STE M
CINCINNATI OH
45255-4231
US

IV. Provider business mailing address

7545 BEECHMONT AVE STE M
CINCINNATI OH
45255-4231
US

V. Phone/Fax

Practice location:
  • Phone: 513-321-4333
  • Fax: 513-232-0100
Mailing address:
  • Phone: 513-321-4333
  • Fax: 513-232-0100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number35.143970
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.143970
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: