Provider Demographics
NPI:1467688093
Name:RAYAPUDI, KRISHNA M (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISHNA
Middle Name:M
Last Name:RAYAPUDI
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 1:4600 LEAP CT
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9822
Mailing Address - Country:US
Mailing Address - Phone:614-385-5900
Mailing Address - Fax:614-385-5935
Practice Address - Street 1:4600 LEAP CT
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026
Practice Address - Country:US
Practice Address - Phone:614-385-5900
Practice Address - Fax:614-385-5935
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 125110207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0121807Medicaid
OH0121807Medicaid