Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 35.133440 | OH |
Y | 2080P0202X | Pediatric Cardiologist | 35.133440 | OH |
NPI | 1043516735 |
---|---|
Provider Name | Dr. Pradeepkumar Charla |
First Address | Brecksville, OH 44141-3539 |
Second Address | Brooklyn, NY 11215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2011 |
Last Update Date | 15/07/2018 |