Provider Demographics
NPI:1023264280
Name:HEBSUR, SHRINIVAS M (MD)
Entity type:Individual
Prefix:DR
First Name:SHRINIVAS
Middle Name:M
Last Name:HEBSUR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-7677
Mailing Address - Fax:614-293-1456
Practice Address - Street 1:6700 UNIVERSITY BLVD FL 5
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-3508
Practice Address - Country:US
Practice Address - Phone:614-293-7677
Practice Address - Fax:614-293-5614
Is Sole Proprietor?:No
Enumeration Date:2008-08-07
Last Update Date:2024-09-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301110559207RC0001X, 207RC0001X
OH35.151457207RC0001X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M32310Medicare PIN