Individual
ACHALA VAGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
234 GOODMAN ST, DEPARTMENT OF RADIOLOGY, CINCINNATI, OH 45267-1000
(513) 584-2146
(513) 584-0431
Mailing address
PO BOX 636256 CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 245-3107
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35-08-6532
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000538779
ANTHEM
OH
05
—
200862250
—
IL
05
—
2732869
—
OH
01
—
325886
AMERIGROUP
OH
05
—
7100018770
—
KY
01
—
7163925
AETNA
OH
Enumeration date
08/29/2006
Last updated
02/21/2018
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