Basic Information
| Provider Information | |||||||||
| NPI: | 1346486446 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SRIVASTAVA | ||||||||
| FirstName: | ADARSH | ||||||||
| MiddleName: | KUMAR | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 10500 MONTGOMERY RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452424402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138652246 | ||||||||
| FaxNumber: | 5138655596 | ||||||||
| Practice Location | |||||||||
| Address1: | 10500 MONTGOMERY RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138652246 | ||||||||
| FaxNumber: | 5138655596 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2008 | ||||||||
| LastUpdateDate: | 08/05/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 35 123374 | OH | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 01077730A | IN | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207R00000X | 2021-00949 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 35123374 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 01077730A | IN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0200X | 01077730A | IN | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RC0200X | 35123374 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0108950 | 05 | OH | MEDICAID |