Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Vidyashankar B Revan, MD

Individual provider Allergy & Immunology Physician · NPI 1194882571

Vidyashankar B Revan, MD is an Allergy/Immunology in Wilmington, Ohio. Qualified in 1987, 39 years ago. Practices with Psf PLLC, a 99-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
39
Licensed in
OH
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

110 Fairway Dr Ste # 2
Wilmington, OH 45177-8756
Phone: (937) 655-9179
Fax: (937) 655-9139
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Allergy & Immunology Physician (primary) Taxonomy 207K00000X · Licence 35080833 (OH)

Record details

NPI number1194882571
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 3, 2007
Last updated in NPPESMay 26, 2021
Certification dateMay 26, 2021
Mailing address9800 Shelbyville Rd Ste 220, Louisville, KY 40223-2992

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyALLERGY/IMMUNOLOGY
Medical schoolOTHER
Graduated 1987 (39 years in practice)
Group practice Psf Pllc — 99 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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