Individual
DR. BALASUBRAMANIAM CHITRABANU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3120 PARKWAY ST NW, SUITE A, CANTON, OH 44708-3981
(330) 452-9460
(330) 452-9520
Mailing address
3120 PARKWAY ST NW, SUITE A, CANTON, OH 44708-3981
(330) 452-9460
(330) 452-9520
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35044268C
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000130642
ANTHEM
OH
05
—
0429414
—
OH
01
—
1376559799
GROUP NPI
OH
01
—
4301590
AETNA
OH
Enumeration date
07/07/2005
Last updated
12/17/2012
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