Provider Demographics
NPI:1699657957
Name:SUNDARARAGHAVAN, SREEKANTHAN (MBBS, DCH)
Entity type:Individual
Prefix:
First Name:SREEKANTHAN
Middle Name:
Last Name:SUNDARARAGHAVAN
Suffix:
Gender:M
Credentials:MBBS, DCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3417 BURCH AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-2003
Mailing Address - Country:US
Mailing Address - Phone:859-323-6754
Mailing Address - Fax:
Practice Address - Street 1:740, S LIMESTONE SECOND FLOOR WIND D ROOM L203
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-323-6754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0771432080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Multi-Specialty