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1194882571
VIDYASHANKAR B REVAN
WILMINGTON, OH
NPI
1194882571
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Former Name
VIDYASHANKAR B REVANNASIDDAPPA
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207K00000X Allergy & Immunology
(Licence: OH 35080833)
Enumeration Date
2007-01-03
Last Update Date
2021-05-26
Business Address
VIDYASHANKAR B REVAN M.D
110 FAIRWAY DR SUITE # 2
WILMINGTON, OH 45177-8756
Phone number: 937-655-9179
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Mailing Address
VIDYASHANKAR B REVAN M.D
9800 SHELBYVILLE RD STE 220
LOUISVILLE, KY 40223-2992
Phone number: 502-429-8585
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