Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 30.024902 | OH |
NPI | 1194054650 |
---|---|
Provider Name | Dr. Sanjay Karunagaran |
First Address | Medina, OH 44256-5389 |
Second Address | Medina, OH 44256-5389 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2009 |
Last Update Date | 22/07/2019 |