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General NPI Number Information
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NPI Number | 1598739963
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Entity Type | Individual
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Provider Name | RAMAMOHAN CHUNDURI MD
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Gender | Male
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 01/09/2020
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Provider Practice Location Address
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Address Line | 7111 N MAIN ST STE 10
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City | DAYTON
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State | OH
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Zip | 45415-2558
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Country | US
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Telephone | 937-277-2121
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Fax | 937-277-2213
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Provider Business Mailing Address
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Address Line | 7111 N MAIN ST STE 10
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City | DAYTON
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State | OH
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Zip | 45415-2558
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Country | US
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Telephone | 937-836-7130
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Fax | 937-836-9727
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 036281
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35.036821
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License Number State | OH
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