Provider Demographics
NPI:1942300264
Name:PURI, VANSHIPAL S (MD)
Entity Type:Individual
Prefix:DR
First Name:VANSHIPAL
Middle Name:S
Last Name:PURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7502 STATE RD
Mailing Address - Street 2:SUITE 2210
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-2596
Mailing Address - Country:US
Mailing Address - Phone:513-624-2070
Mailing Address - Fax:513-624-2077
Practice Address - Street 1:7502 STATE RD
Practice Address - Street 2:SUITE 2210
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-2596
Practice Address - Country:US
Practice Address - Phone:513-624-2070
Practice Address - Fax:513-624-2077
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.080832207RC0000X, 207RI0011X, 207UN0901X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0997122Medicaid
OH4204734Medicare PIN
OHP67066Medicare UPIN