Provider Demographics
NPI:1194933192
Name:PERALI, HARI KRISHNA V (MD)
Entity type:Individual
Prefix:
First Name:HARI KRISHNA
Middle Name:V
Last Name:PERALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 ELM ST
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-2173
Mailing Address - Country:US
Mailing Address - Phone:740-845-4100
Mailing Address - Fax:740-845-0323
Practice Address - Street 1:214 ELM ST
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-2173
Practice Address - Country:US
Practice Address - Phone:740-845-4100
Practice Address - Fax:740-845-0323
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35093986207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2990205Medicaid
OHH168803Medicare PIN
OHH168800Medicare PIN
OH4285491Medicare PIN