Provider Demographics
NPI:1952346454
Name:KATNENI, RANJIT (MD)
Entity type:Individual
Prefix:
First Name:RANJIT
Middle Name:
Last Name:KATNENI
Suffix:
Gender:M
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 229
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45343-0229
Mailing Address - Country:US
Mailing Address - Phone:513-618-7430
Mailing Address - Fax:513-280-8868
Practice Address - Street 1:6730 ROOSEVELT AVE
Practice Address - Street 2:STE 303
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45005-5730
Practice Address - Country:US
Practice Address - Phone:513-618-7430
Practice Address - Fax:513-280-8868
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35082600207R00000X
OH35-082600208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00049138OtherMEDICARE RAILROAD
KY7100190620Medicaid
IN200987680Medicaid
P00808058OtherRR MEDICARE
OH2413516Medicaid
OH4150815Medicare PIN
H87935Medicare UPIN
OH4150812Medicare PIN
P00808058OtherRR MEDICARE
KY7100190620Medicaid
OH4150812Medicare PIN