Provider Demographics
NPI:1104856236
Name:RAMANAVARAPU, SAMPATH K (MD)
Entity Type:Individual
Prefix:
First Name:SAMPATH
Middle Name:K
Last Name:RAMANAVARAPU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 638269
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:330-722-8707
Mailing Address - Fax:330-723-5679
Practice Address - Street 1:970 E WASHINGTON ST STE 2E
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-2181
Practice Address - Country:US
Practice Address - Phone:330-722-8707
Practice Address - Fax:330-723-5679
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35062927207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0997739Medicaid
OH060044166OtherRAILROAD MEDICARE
OHG01195Medicare UPIN
OH060044166OtherRAILROAD MEDICARE