Vidyashankar B Revan
Allergist & Immunologist
110 Fairway Dr Suite # 2
Wilmington
, Ohio 45177-8756
Vidyashankar B Revan
Allergist & Immunologist
110 Fairway Dr Suite # 2
Wilmington
, Ohio 45177-8756
(502) 753-0889
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About
Features
Specialties
- Allergist & Immunologist
Languages spoken
- English
Location
First Address
- Vidyashankar B Revan
- 9800 Shelbyville Rd Ste 220
- Louisville, KY
- Zip : 40223-2992
- Fax : (502) 753-0889
- Phone : (502) 429-8585
Second Address
- Vidyashankar B Revan
- 110 Fairway Dr Suite # 2
- Wilmington, OH
- Zip : 45177-8756
- Fax : (937) 655-9139
- Phone : (937) 655-9179
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207K00000X | Allergist & Immunologist | 35080833 | OH |
National Provider Identifier
| NPI | 1194882571 |
|---|---|
| Provider Name | Vidyashankar B Revan |
| First Address | Louisville, KY 40223-2992 |
| Second Address | Wilmington, OH 45177-8756 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/01/2007 |
| Last Update Date | 26/05/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 2321660 | (05) | OH |
| H60978 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.