NPIMap

Organization Active NPI

Sujana K Patibandla MD Inc

  • Specialist
  • Canton, OH
National Provider Identifier
1487988028
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
35048212 Issued in OH
Legal business name
SUJANA K PATIBANDLA MD INC
Practice address
4186 Holiday St NW
Canton, OH 44718-2532
Phone
(330) 492-5210
Fax
(330) 492-5230
NPI assigned
Sep 30, 2009
Last updated
Sep 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sujana K Patibandla, MDNPI 1417916438
Title
Owner
Phone
(330) 492-5210

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 35048212 OH Primary

Addresses

Primary practice location

4186 Holiday St NW
Canton, OH 44718-2532

Mailing address

4186 Holiday St NW
Canton, OH 44718-2532
Phone (330) 492-5210

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254268800000",
    "number": "1487988028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4186 HOLIDAY ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182532",
            "telephone_number": "330-492-5210",
            "fax_number": "330-492-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4186 HOLIDAY ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182532",
            "telephone_number": "330-492-5210",
            "fax_number": "330-492-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUJANA K PATIBANDLA MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-30",
        "last_updated": "2009-09-30",
        "status": "A",
        "authorized_official_last_name": "PATIBANDLA",
        "authorized_official_first_name": "SUJANA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-492-5210",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "35048212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.