Provider Demographics
NPI:1174728885
Name:SADHU, SRIKANTH (MD)
Entity type:Individual
Prefix:
First Name:SRIKANTH
Middle Name:
Last Name:SADHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MEDICAL CENTER DR
Mailing Address - Street 2:STE 290A
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-5200
Mailing Address - Country:US
Mailing Address - Phone:513-425-7135
Mailing Address - Fax:513-420-4662
Practice Address - Street 1:200 MEDICAL CENTER DR
Practice Address - Street 2:STE 290A
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45005-5200
Practice Address - Country:US
Practice Address - Phone:513-425-7135
Practice Address - Fax:513-420-4662
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.098771207RI0011X
KY41792207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000584957OtherBCBS
KY7100049100Medicaid
OH0065350Medicaid
OH0065350Medicaid
KY00190010Medicare PIN