Individual
AMARESHWAR PODUGU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2726 FULTON DR NW, CANTON, OH 44718-3506
(330) 455-5011
Mailing address
2726 FULTON DR NW, CANTON, OH 44718-3506
(330) 455-5011
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
35-130380
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0236878
—
OH
Enumeration date
07/14/2011
Last updated
05/12/2020
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