Basic Information
Provider Information
NPI: 1336672120
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KRIMPURI
FirstName: RAMAN
MiddleName: DEEP
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 340 S BROADWAY ST
Address2:  
City: AKRON
State: OH
PostalCode: 443081529
CountryCode: US
TelephoneNumber: 3302533100
FaxNumber:  
Practice Location
Address1: 2500 METROHEALTH DR
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441091900
CountryCode: US
TelephoneNumber: 2167787800
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/07/2017
LastUpdateDate: 10/13/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/13/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X35.140890OHY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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