Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35.131126 | OH |
N | 111NI0900X | Internist | 35.131126 | OH |
NPI | 1003235912 |
---|---|
Provider Name | Dr. Sydulu G Bathini |
First Address | Columbus, OH 43214-3984 |
Second Address | Columbus, OH 43214-3984 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2014 |
Last Update Date | 21/08/2017 |