Arvind Padubidri, MD, Inc – Specialist in Warren, OH

Key facts

NPI: 1275715658
Entity type: Organization (NPI type 2)
Primary specialty: Specialist 174400000X
License: 35-07-7133P (OH)
Legal business name: ARVIND PADUBIDRI, MD, INC
Practice address: 1924 E Market St
Warren, OH 44483-6618
Phone: (330) 392-7474
Fax: (330) 399-1733
NPI assigned: Nov 28, 2007
Organization subpart: No

Authorized official

Name: Dr. Arvind Padubidri, MD
Title: President/Owner
Phone: (330) 392-7474

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Specialist Group: 193400000X SINGLE SPECIALTY GROUP	174400000X	35-07-7133P	OH	Yes

Addresses

Primary practice location

1924 E Market St
Warren, OH 44483-6618

Mailing address

1924 E Market St
Warren, OH 44483-6618
Phone (330) 392-7474

Other identifiers

Identifier	Type	State	Issuer
2177264	Medicaid	OH

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 31, 2011.

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306800000000",
    "number": "1275715658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444836618",
            "telephone_number": "330-392-7474",
            "fax_number": "330-399-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444836618",
            "telephone_number": "330-392-7474",
            "fax_number": "330-399-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARVIND PADUBIDRI, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2011-05-31",
        "status": "A",
        "authorized_official_last_name": "PADUBIDRI",
        "authorized_official_first_name": "ARVIND",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "330-392-7474",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "35-07-7133P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2177264",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

All providers in Warren, OH · Specialist in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 31, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.