Basic Information
| Provider Information | |||||||||
| NPI: | 1952346454 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KATNENI | ||||||||
| FirstName: | RANJIT | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 229 | ||||||||
| Address2: | |||||||||
| City: | MIAMISBURG | ||||||||
| State: | OH | ||||||||
| PostalCode: | 453430229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136187430 | ||||||||
| FaxNumber: | 5132808868 | ||||||||
| Practice Location | |||||||||
| Address1: | 6730 ROOSEVELT AVE | ||||||||
| Address2: | STE 303 | ||||||||
| City: | MIDDLETOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450055730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136187430 | ||||||||
| FaxNumber: | 5132808868 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2006 | ||||||||
| LastUpdateDate: | 10/19/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35082600 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 35-082600 | OH | N | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | P00049138 | 01 | OH | MEDICARE RAILROAD | OTHER | 7100190620 | 05 | KY | MEDICAID | 200987680 | 05 | IN | MEDICAID | P00808058 | 01 | RR MEDICARE | OTHER | 2413516 | 05 | OH | MEDICAID |