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Organization
SHANI VATURI MD LLC
Active
Organization
SHANI VATURI MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANI VATURI MD (PRESIDENT)
(330) 448-3060
Entity
Organization
Contact information
Practice address
7264 WARREN SHARON RD, BROOKFIELD, OH 44403-9665
(330) 448-3060
(330) 448-2555
Mailing address
PO BOX 1208, HERMITAGE, PA 16148-0208
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35062216
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014975420002
—
PA
05
—
0930103
—
OH
Enumeration date
04/13/2007
Last updated
08/29/2007
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