Basic Information
| Provider Information | |||||||||
| NPI: | 1336100965 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DIGESTIVE HEALTH CONSULTANTS, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1037 N MAIN ST | ||||||||
| Address2: | SUITE B | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3309209497 | ||||||||
| FaxNumber: | 3309230508 | ||||||||
| Practice Location | |||||||||
| Address1: | 275 GRAHAM RD | ||||||||
| Address2: | SUITE 11 | ||||||||
| City: | CUYAHOGA FALLS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442232203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3309201212 | ||||||||
| FaxNumber: | 3309207533 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BANDI | ||||||||
| AuthorizedOfficialFirstName: | RAMAKRISHNA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3309230094 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 35044350B | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 2273776 | 05 | OH | MEDICAID |