Individual
DR. BHANU PRAKASH YADIKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6730 ROOSEVELT AVE STE 303, MIDDLETOWN, OH 45005
(513) 874-0486
Mailing address
PO BOX 229, MIAMISBURG, OH 45343-0229
(513) 894-0486
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
27163
WV
207Q00000X
Family Medicine Physician
Primary
35-146420
OH
208M00000X
Hospitalist Physician
27163
WV
208M00000X
Hospitalist Physician
35-146420
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0287260
—
OH
05
—
1669705091
—
WV
05
—
7100535230
—
KY
Enumeration date
09/17/2009
Last updated
10/19/2022
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