Organization
SPRINGFIELD HEART SURGEONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SURENDER R NERAVETLA MD (MD / OWNER)
(937) 215-9076
Entity
Organization
Contact information
Practice address
1671 N LIMESTONE ST, SPRINGFIELD, OH 45503-2646
(937) 324-5511
(937) 398-0652
Mailing address
1671 N LIMESTONE ST, SPRINGFIELD, OH 45503-2646
(937) 324-5511
(937) 398-0652
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2642868
—
OH
Enumeration date
05/27/2006
Last updated
11/10/2020
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