Provider Demographics
NPI:1609828367
Name:PRATTIPATI, ARUNA K (MD)
Entity Type:Individual
Prefix:
First Name:ARUNA
Middle Name:K
Last Name:PRATTIPATI
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:PO BOX 1013
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-8013
Mailing Address - Country:US
Mailing Address - Phone:937-335-9998
Mailing Address - Fax:937-335-9840
Practice Address - Street 1:3006 N COUNTY ROAD 25A
Practice Address - Street 2:101
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-1373
Practice Address - Country:US
Practice Address - Phone:937-339-9030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35083448207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000385871OtherBC/BS
OH2475245Medicaid
OH000000336860OtherBCBS
OH000000336860OtherBCBS
OH000000385871OtherBC/BS
OHPR4121864Medicare PIN
OHPR4121863Medicare PIN