Devanathan, Srinivasan
Devanathan, Srinivasan is an individual health care provider with primary practice located at 8028 Carnegie Blvd. Suite 600, Fort Wayne IN 46804-5790. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Devanathan, Srinivasan can be contacted via phone (260) 969-7100.Contact Information
Primary practice address
8028 Carnegie Blvd. Suite 600
Fort Wayne IN 46804-5790
Phone: (260) 969-7100
Fax: (260) 969-7263
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 01059028A | Indiana |
| Allopathic & Osteopathic Physicians / Sleep Medicine | 207RS0012X | 01059028A | Indiana |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 01059028 | Indiana |
Profile Details
| NPI number | 1104874452 |
|---|---|
| LBN Legal business name | Devanathan, Srinivasan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 5th, 2006 |
| Last updated | Oct 17th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104874452 | NPPES |
| Indiana | MEDICAID | 200481860 | |
| Indiana | Other | P00867128 | |
| Indiana | Other | 000000670561 |
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