Provider Demographics
NPI:1699769968
Name:AMIRTHALINGAM, KOWRIAH N V (MD)
Entity type:Individual
Prefix:DR
First Name:KOWRIAH
Middle Name:N
Last Name:AMIRTHALINGAM
Suffix:V
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:K
Other - Middle Name:N
Other - Last Name:AMIR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4694 BELMONT AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1012
Mailing Address - Country:US
Mailing Address - Phone:330-480-4080
Mailing Address - Fax:330-480-4078
Practice Address - Street 1:4694 BELMONT AVE STE 2
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1012
Practice Address - Country:US
Practice Address - Phone:330-480-4080
Practice Address - Fax:330-480-4078
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-01
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35048771A207RP1001X
OH35.048771207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1699769968OtherNPI
OH0514143Medicaid
OH1699769968OtherNPI
OHAM0530571Medicare ID - Type Unspecified