Individual provider · NPI-1

Ganesh Athappan, MD

Internal Medicine, Interventional Cardiology · Port Charlotte, FL

NPI number1770749392
StatusActive
Last updated in NPPESFeb 11, 2025

Details

NPI
1770749392
Entity type
Individual (NPI-1)
Name
Ganesh Athappan
Credential
MD
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 3, 2008
Certification date
Feb 11, 2025
Last updated
Feb 11, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207RI0011X Internal Medicine, Interventional CardiologyME133681FLYes
207R00000X Internal Medicine235682MA

Practice location

3340 Tamiami Trl
Port Charlotte, FL 33952-8088

Phone 941-764-5858 · Fax 941-764-1657

Mailing address

2675 Winkler Ave Fl 2
Fort Myers, FL 33901-9342

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