Individual
ASHOK V KONDRU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2112 LAKE AVE, ASHTABULA, OH 44004-3436
(440) 998-0322
(440) 998-4525
Mailing address
PO BOX 522, ASHTABULA, OH 44005-0522
(440) 998-0322
(440) 998-4525
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
35063118
OH
207RG0100X
Gastroenterology Physician
70312
WI
207RG0100X
Gastroenterology Physician
PT18475
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0873210
—
OH
01
—
100004247
MEDICARE RR GROUP PTAN
OH
05
—
2803854
—
OH
01
—
9370811
MEDICARE GROUP
OH
01
—
DG1495
MEDICARE RR GROUP#
OH
Enumeration date
12/15/2005
Last updated
06/24/2022
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