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General NPI Number Information
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NPI Number | 1255329280
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Entity Type | Individual
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Provider Name | DAMODAR POUDEL MD
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Gender | Male
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 7335 E LIVINGSTON AVE
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City | REYNOLDSBURG
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State | OH
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Zip | 43068-3089
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Country | US
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Telephone | 614-328-9200
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Fax | 614-328-9300
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Provider Business Mailing Address
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Address Line | 1049 WESTERN AVE PO BOX 188
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-1104
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Country | US
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Telephone | 740-773-4366
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Fax | 740-775-7855
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35084100P
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License Number State | OH
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