Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 53087 | KY |
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | TP579 | KY |
N | 207RC0000X | Internist - Cardiovascular Disease | 35087848 | OH |
N | 207RC0000X | Internist - Cardiovascular Disease | TP579 | KY |
NPI | 1538108881 |
---|---|
Provider Name | Deepthi R Mosali |
First Address | Cincinnati, OH 45263-5283 |
Second Address | Edgewood, KY 41017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 21/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2670631 | (05) | OH |
I53220 | (02) | |
P01022280 | RAILROAD MEDICARE (01) | OH |