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Individual

CHANNAGIRI PHANINDRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
12301,SNOW RD, KAISER PERMANENTE, PARMA, OH 44130-1002
(216) 362-2741
Mailing address
5391 POTOMAC DR, BRECKSVILLE, OH 44141-2827
(440) 838-5032
(440) 838-5032

Taxonomy

Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
3504-4844
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0473438
OH
Enumeration date
12/11/2006
Last updated
07/08/2007
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