| Challa Ajit, M.d. Llc | |
|
2355 Derr Rd Springfield OH 45503-2433 | |
| (937) 568-7070 | |
| (937) 629-3285 |
| Full Name | Challa Ajit, M.d. Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2355 Derr Rd, Springfield, Ohio |
| Authorized Official Name and Position | Challa Ajit (OWNER) |
| Authorized Official Contact | 9375687070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Challa Ajit, M.d. Llc 2355 Derr Rd Springfield OH 45503-2433 Ph: (937) 568-7070 | Challa Ajit, M.d. Llc 2355 Derr Rd Springfield OH 45503-2433 Ph: (937) 568-7070 |
| NPI Number | 1629142815 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 03/25/2008 |
| Medicare PECOS PAC ID | 7012916232 |
|---|---|
| Medicare Enrollment ID | O20061215000148 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629142815 | NPI | - | NPPES |
| 2388269 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 35082392 (Ohio) | Primary |
| Provider Name | Afaf Zayat |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1760587265 PECOS PAC ID: 9032008669 Enrollment ID: I20040312000189 |
| Provider Name | Alan Prok |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1255380630 PECOS PAC ID: 4587675632 Enrollment ID: I20060606000000 |
| Provider Name | Ronald C Chiu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1023126265 PECOS PAC ID: 4486659067 Enrollment ID: I20061004000079 |
| Provider Name | Challa Ajit |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1598778805 PECOS PAC ID: 6608864004 Enrollment ID: I20061215000114 |
| Provider Name | Rebecca R Balaj |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1023001989 PECOS PAC ID: 7113811183 Enrollment ID: I20070827000008 |
| Provider Name | Daniel L Hood |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1922095819 PECOS PAC ID: 1759275720 Enrollment ID: I20080313000358 |
| Provider Name | Luke Wibowo |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1861487068 PECOS PAC ID: 0749355840 Enrollment ID: I20080826000026 |
| Provider Name | Akeek Bhatt |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1962609578 PECOS PAC ID: 4880730712 Enrollment ID: I20111004000784 |
| Provider Name | Allen Lee Stephens |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1184890121 PECOS PAC ID: 5092879312 Enrollment ID: I20130315000449 |
| Provider Name | Krishna Mohan Rayapudi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1467688093 PECOS PAC ID: 8123163722 Enrollment ID: I20150406001691 |
| Provider Name | Hongliu Sun |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1518213693 PECOS PAC ID: 4688976798 Enrollment ID: I20160714002125 |
| Provider Name | Heidi Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659888907 PECOS PAC ID: 0042572273 Enrollment ID: I20180327002471 |
| Provider Name | Sergei Rafael Guma |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1699186445 PECOS PAC ID: 6406199959 Enrollment ID: I20190523002882 |
| Provider Name | Kandarp K Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801815352 PECOS PAC ID: 2062421472 Enrollment ID: I20200429002485 |
| Provider Name | Adine M Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538702162 PECOS PAC ID: 1456782523 Enrollment ID: I20200506001403 |
| Provider Name | Hebin Song |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1649624222 PECOS PAC ID: 1456760263 Enrollment ID: I20210507000799 |
| Provider Name | John R Debanto |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033175922 PECOS PAC ID: 5294632667 Enrollment ID: I20210714001775 |
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