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General NPI Number Information
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NPI Number | 1891101986
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Entity Type | Individual
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Provider Name | RAVITEJA GUDDETI MD
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Gender | Male
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 2123 AUBURN AVE STE 428
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City | CINCINNATI
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State | OH
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Zip | 45219-2906
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Country | US
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Telephone | 513-206-1222
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Fax | 513-585-2095
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Provider Business Mailing Address
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Address Line | 2139 AUBURN AVE. 4-7
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City | CINCINNATI
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State | OH
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Zip | 45219-2906
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Country | US
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Telephone | 513-263-9402
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Fax | 513-564-2918
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 2021-00562
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License Number State | NC
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