Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 35-07-3851 | OH |
NPI | 1023097003 |
---|---|
Provider Name | Ramana Podugu |
First Address | Canton, OH 44710-1702 |
Second Address | Canton, OH 44710-1702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2006 |
Last Update Date | 17/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2266104 | (05) | OH |
H35485 | (02) | OH |