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General NPI Number Information
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NPI Number | 1104265156
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Entity Type | Individual
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Provider Name | ADARSH VENNEPUREDDY M.D
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Gender | Male
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Dates
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Enumeration Date | 06/21/2013
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 417 QUARRY LAKES DR
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City | SANDUSKY
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State | OH
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Zip | 44870-8635
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Country | US
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Telephone | 419-626-9090
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Fax | 419-626-6319
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Provider Business Mailing Address
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Address Line | 6672 LIST ST NW
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City | CANTON
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State | OH
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Zip | 44708-6419
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 35.135816
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License Number State | OH
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