Provider Demographics
NPI:1942528013
Name:AZAD, ASHRUTH (MD)
Entity Type:Individual
Prefix:
First Name:ASHRUTH
Middle Name:
Last Name:AZAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PUTHIYAPURAYIL
Other - Middle Name:AZAD
Other - Last Name:ASHRUTH CHUNDNGAPUYIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:730 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-4602
Mailing Address - Country:US
Mailing Address - Phone:419-226-4310
Mailing Address - Fax:419-226-4315
Practice Address - Street 1:730 W MARKET ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-4602
Practice Address - Country:US
Practice Address - Phone:419-226-4310
Practice Address - Fax:419-226-4315
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP345207RN0300X
KY48154207RN0300X
OH35.122111207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology