Individual
HANUMANTHARAO MEDARAMETLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 MATTHEW ST, MARIETTA, OH 45750-1635
(740) 376-1994
(740) 376-1940
Mailing address
PO BOX 449, MARIETTA, OH 45750-0449
(740) 374-4500
(740) 374-5887
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35054969
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000505200
ANTHEM
—
01
—
000000643495
ANTHEM
OH
05
—
1803285000
—
WV
05
—
2188823
—
OH
01
—
P00130258
MEDICARE RAILROAD
—
01
—
P00385096
RRMCR
OH
Enumeration date
06/07/2006
Last updated
10/06/2011
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