Provider Demographics
NPI:1518957919
Name:HANUMANTHU, SAI K (MD)
Entity Type:Individual
Prefix:DR
First Name:SAI
Middle Name:K
Last Name:HANUMANTHU
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 1:3219 CLIFTON AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220-3027
Mailing Address - Country:US
Mailing Address - Phone:513-861-1260
Mailing Address - Fax:513-872-7149
Practice Address - Street 1:3219 CLIFTON AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-3027
Practice Address - Country:US
Practice Address - Phone:513-861-1260
Practice Address - Fax:513-872-7149
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-078989174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2268899Medicaid
OHP00415378OtherRAILROAD MEDICARE
OHHA4051262Medicare PIN
OHH030540Medicare PIN
OHHA4051264Medicare PIN
OHP00415378OtherRAILROAD MEDICARE
OHH16625Medicare UPIN
OHHA4051266Medicare PIN