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General NPI Number Information
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NPI Number | 1104856236
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Entity Type | Individual
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Provider Name | SAMPATH K RAMANAVARAPU MD
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Gender | Male
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 970 E WASHINGTON ST STE 2E
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City | MEDINA
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State | OH
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Zip | 44256-2181
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Country | US
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Telephone | 330-722-8707
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Fax | 330-723-5679
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Provider Business Mailing Address
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Address Line | PO BOX 638269
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City | CINCINNATI
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State | OH
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Zip | 45263-0001
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Country | US
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Telephone | 330-722-8707
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Fax | 330-723-5679
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 35062927
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License Number State | OH
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