MEDICARE: ROHINI KALISETTI M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207R00000X	Internal Medicine Physician	131054	OH

General Provider Information

NPI Number	:	1326452111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROHINI KALISETTI M.D

Provider Business Mailing Address
First Line	:	1261 WOOSTER RD STE 220
Second Line	:
City	:	MILLERSBURG
State	:	OH
Zip	:	44654-1570
Country	:	US
Telephone Number	:	330-893-1318
Fax Number	:

Provider Business Practice Location Address
First Line	:	1261 WOOSTER RD STE 220
Second Line	:
City	:	MILLERSBURG
State	:	OH
Zip	:	44654-1570
Country	:	US
Telephone Number	:	330-893-1318
Fax Number	:	330-893-1485

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2014
Last Update Date	:	05/25/2022

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