Organization Name: | RS MEDICAL GROUP PC |
NPI Number: | 1558535807 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KRISHNA M RAGOTHAMAN (PRESIDENT) |
Mailing Address: | 5757 Monclova Rd Suite 17 Maumee |
State: | OH US |
Postal Code: | 435371863 |
Phone Number: | 4198870896 |
Fax Number: | 4198933046 |
NPI Enumeration Date: | 04/17/2008 |
NPI Last Update Date: | 04/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 35068996 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |