Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 35.097908 | OH |
N | 208600000X | Surgeon | 35.097908 | OH |
Y | 2086X0206X | Surgical Oncologist | 35.097908 | OH |
NPI | 1053553586 |
---|---|
Provider Name | Shyam S R Allamaneni |
First Address | Cincinnati, OH 45236-6706 |
Second Address | Cincinnati, OH 45236-6706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2009 |
Last Update Date | 29/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000531487001 | BCBS OF WESTERN NY (01) | |
0053308 | (05) | OH |
03106214 | (05) | NY |
1715650 | INDEPENDENT HEALTH (01) |