Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 35.130526 | OH |
NPI | 1083902621 |
---|---|
Provider Name | Ravi Sunderkrishnan |
First Address | Mayfield Heights, OH 44124-2299 |
Second Address | Mayfield Heights, OH 44124-2299 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2011 |
Last Update Date | 13/12/2019 |