MEDICARE: MOLAKALMURU VAMADEVAMURTHY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD038181L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285615229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOLAKALMURU VAMADEVAMURTHY MD

Provider Business Mailing Address
First Line	:	1719 UNION AVE
Second Line	:	SUITE A
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-2146
Country	:	US
Telephone Number	:	724-226-2128
Fax Number	:	724-226-2498

Provider Business Practice Location Address
First Line	:	1719 UNION AVE
Second Line	:	SUITE A
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-2146
Country	:	US
Telephone Number	:	724-226-2128
Fax Number	:	724-226-2498

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	12/09/2015

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