Provider Demographics
NPI:1346242070
Name:UMAPATHY, PRIYADHARSHINI (MD)
Entity Type:Individual
Prefix:MRS
First Name:PRIYADHARSHINI
Middle Name:
Last Name:UMAPATHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 CENTER RD
Mailing Address - Street 2:#350
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146
Mailing Address - Country:US
Mailing Address - Phone:440-439-7766
Mailing Address - Fax:440-439-1375
Practice Address - Street 1:88 CENTER RD
Practice Address - Street 2:#350
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146
Practice Address - Country:US
Practice Address - Phone:440-439-7766
Practice Address - Fax:440-439-1375
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2013-08-09
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-04-10
Provider Licenses
StateLicense IDTaxonomies
OH35077657207R00000X
OH35-077657207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2357346Medicaid
OHH33684Medicare UPIN
OH4045144Medicare ID - Type Unspecified
H33684Medicare PIN