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General NPI Number Information
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NPI Number | 1699657957
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Entity Type | Individual
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Provider Name | SREEKANTHAN SUNDARARAGHAVAN MBBS, DCH
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Gender | Male
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 740, S LIMESTONE SECOND FLOOR WIND D ROOM L203
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City | LEXINGTON
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State | KY
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Zip | 40536-0001
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Country | US
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Telephone | 859-323-6754
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Fax | 859-323-3499
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Provider Business Mailing Address
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Address Line | 3417 BURCH AVE
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City | CINCINNATI
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State | OH
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Zip | 45208-2003
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Country | US
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Telephone | 859-323-6754
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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 | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | TP680
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 35.077143
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License Number State | OH
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