Ambalavanan, Geetha C
Ambalavanan, Geetha C is an individual health care provider with primary practice located at 2180 Gateway Dr , Fairborn OH 45324-6356. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Ambalavanan, Geetha C can be contacted via phone (937) 208-8155.Contact Information
Primary practice address
2180 Gateway Dr
Fairborn OH 45324-6356
Phone: (937) 208-8155
Fax: (937) 208-8140
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 35-089208 | Ohio |
Profile Details
| NPI number | 1780899633 |
|---|---|
| LBN Legal business name | Ambalavanan, Geetha C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 14th, 2007 |
| Last updated | Dec 6th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780899633 | NPPES |
| Ohio | MEDICAID | 2781673 |
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