Individual
ANANTHA LAKSHMI BRAHMAMDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8240 NORTHCREEK DR, CINCINNATI, OH 45236-2377
(513) 853-7555
(513) 853-7550
Mailing address
PO BOX 636256 CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5501
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-124514
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200883820
—
IN
05
—
2565399
—
OH
05
—
470444616A
—
GA
05
—
G56681
—
SC
01
—
P00903550
RAILROAD MEDICARE PTAN
IN
Enumeration date
05/28/2006
Last updated
12/21/2020
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