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General NPI Number Information
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NPI Number | 1164586715
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Entity Type | Organization
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Legal Business Name | RICHLAND CARDIOLOGY
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1221 S TRIMBLE RD SUITE B2
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City | MANSFIELD
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State | OH
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Zip | 44907-2200
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Country | US
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Telephone | 419-631-7183
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 S TRIMBLE RD SUITE B2
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City | MANSFIELD
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State | OH
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Zip | 44907-2200
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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 | MD
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Name | PAMMAL SURESH
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Credential |
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Telephone | 419-631-7183
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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 | 35056352
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License Number State | OH
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