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Organization

SUJANA K PATIBANDLA MD INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUJANA K PATIBANDLA MD (OWNER)
(330) 492-5210
Entity
Organization

Contact information

Practice address
4186 HOLIDAY ST NW, CANTON, OH 44718-2532
(330) 492-5210
(330) 492-5230
Mailing address
4186 HOLIDAY ST NW, CANTON, OH 44718-2532
(330) 492-5210
(330) 492-5230

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35048212
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0505742
OH
Enumeration date
09/30/2009
Last updated
09/30/2009
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