Provider Demographics
NPI:1689990764
Name:SRIRAM, SRINATH (MD)
Entity Type:Individual
Prefix:
First Name:SRINATH
Middle Name:
Last Name:SRIRAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:770 BALGREEN DR
Mailing Address - Street 2:FL 1
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-4106
Mailing Address - Country:US
Mailing Address - Phone:419-522-0320
Mailing Address - Fax:
Practice Address - Street 1:1800 ZOLLINGER RD FL 3
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2800
Practice Address - Country:US
Practice Address - Phone:614-293-4925
Practice Address - Fax:614-293-5503
Is Sole Proprietor?:No
Enumeration Date:2010-04-14
Last Update Date:2021-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35132159207RP1001X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease