Healthcare Provider Details

I. General information

NPI: 1821008723
Provider Name (Legal Business Name): DR. RANGA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 09/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 SOUTHLAND RD
NEW BREMEN OH
45869
US

IV. Provider business mailing address

PO BOX 98
NEW BREMEN OH
45869-0098
US

V. Phone/Fax

Practice location:
  • Phone: 419-629-3663
  • Fax: 419-629-2783
Mailing address:
  • Phone: 419-629-3663
  • Fax: 419-629-2783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PUTTAGUNTA RANGA
Title or Position: PRESIDENT
Credential: MD
Phone: 419-629-3663