# SPRINGFIELD HEART SURGEONS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659328466
- **Authorized official:** SURENDER R NERAVETLA MD (MD / OWNER)
- **Authorized official phone:** (937) 215-9076

## Contact information

- **Practice address:** 1671 N LIMESTONE ST, SPRINGFIELD, OH 45503-2646
- **Practice address phone:** (937) 324-5511
- **Practice address fax:** (937) 398-0652
- **Mailing address:** 1671 N LIMESTONE ST, SPRINGFIELD, OH 45503-2646
- **Mailing address phone:** (937) 324-5511
- **Mailing address fax:** (937) 398-0652

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | — |
| 2086S0129X | Vascular Surgery Physician | — | — | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/27/2006
- **Last updated:** 11/10/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2642868 | — | OH |