Healthcare Provider Details

I. General information

NPI: 1659353829
Provider Name (Legal Business Name): SAIRAM L ATLURI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 03/24/2020
Certification Date: 03/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7655 5 MILE RD STE 117
CINCINNATI OH
45230-4326
US

IV. Provider business mailing address

7655 5 MILE RD STE 117
CINCINNATI OH
45230-4326
US

V. Phone/Fax

Practice location:
  • Phone: 513-624-7525
  • Fax: 513-624-0578
Mailing address:
  • Phone: 513-624-7525
  • Fax: 513-624-0578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number35068859A
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: