Provider Demographics
NPI:1477545390
Name:SHIVANI, RAMESH K (MD)
Entity Type:Individual
Prefix:
First Name:RAMESH
Middle Name:K
Last Name:SHIVANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 636256 CENTRAL CREDENTIALING
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6256
Mailing Address - Country:US
Mailing Address - Phone:513-245-3107
Mailing Address - Fax:513-585-5511
Practice Address - Street 1:102 TE MAR WAY
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-8530
Practice Address - Country:US
Practice Address - Phone:937-393-5067
Practice Address - Fax:937-393-5652
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH350806032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00128480OtherRAILROAD MEDICARE
OH000000287857OtherANTHEM BCBS
OH2118048OtherCIGNA
OH2337804Medicaid
OH000000287857OtherANTHEM BCBS
OH2337804Medicaid