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Individual

DR. RENGACHARI PAUL DEENADAYALU

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
120 W WENGER RD, ENGLEWOOD, OH 45322
(937) 836-9921
(937) 836-1298
Mailing address
120 W WENGER RD, ENGLEWOOD, OH 45322
(937) 836-9921
(937) 836-1298

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35033785D
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000011356
ANTHEM BCBS
OH
05
0169302
OH
01
1220003
UNITED HEALTHCARE
OH
05
2080948
OH
01
D35785
HUMANA
Enumeration date
01/18/2006
Last updated
07/09/2007
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