Provider Demographics
NPI:1659360915
Name:PARVATHANENI, SIRISH (MD)
Entity Type:Individual
Prefix:
First Name:SIRISH
Middle Name:
Last Name:PARVATHANENI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1005 BELLEFONTAINE AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2851
Mailing Address - Country:US
Mailing Address - Phone:419-227-7702
Mailing Address - Fax:419-227-7991
Practice Address - Street 1:1005 BELLEFONTAINE AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-2851
Practice Address - Country:US
Practice Address - Phone:419-227-7702
Practice Address - Fax:419-227-7991
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35082128P208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)