Healthcare Provider Details

I. General information

NPI: 1568462240
Provider Name (Legal Business Name): NAGARAJA S ORUGANTI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 W MCCREIGHT AVE STE 211
SPRINGFIELD OH
45504-1853
US

IV. Provider business mailing address

4340 CLYO RD STE 200
DAYTON OH
45459-7000
US

V. Phone/Fax

Practice location:
  • Phone: 937-325-3696
  • Fax: 937-325-3713
Mailing address:
  • Phone: 937-534-7330
  • Fax: 937-395-3682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35.079712
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: