Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
VIDYASHANKAR B REVAN, M.D
ActiveVIDYASHANKAR B REVAN, M.D is a Allergy & Immunology healthcare provider located in WILMINGTON, Ohio. NPI 1194882571 is currently active in the NPPES registry. Verify at CMS.
Allergy & Immunology · WILMINGTON, OH
Registration Details
- NPI Number
- 1194882571
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 3, 2007 (19.657019021247 yrs)
- Last Updated
- May 26, 2021
- License
-
35080833 (OH)
Practice Information
- Address
-
110 FAIRWAY DRSUITE # 2WILMINGTON, OH, 451778756Browse OH providers · Browse ZIP 45177
- Phone
- 9376559179
- Fax
- 9376559139
- Primary Specialty
-
Allergy & Immunology
207K00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.