Individual
DR. SREENIVASA RAO CHANAMOLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D,
Contact information
Practice address
770 W HIGH ST, SUITE 240, LIMA, OH 45801-3990
(419) 996-2686
(419) 996-5165
Mailing address
PO BOX 636930, CINCINNATI, OH 45263-0001
(800) 514-4390
(440) 808-3676
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
35088188
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2691305
—
OH
Enumeration date
09/29/2006
Last updated
02/24/2011
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