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NPI Code Detail

MEDICARE: SRINIVAS SAMBARAJU

MEDICARE: SRINIVAS SAMBARAJU
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
1183500000XPharmacist17669MD
2183500000XPharmacist26022672AIN

General Provider Information

NPI Number : 1508461906
Entity Type Code : Individual
Provider Name (Legal Business Name) : SRINIVAS SAMBARAJU
Provider Business Mailing Address
First Line : 3529 CARDINAL WAY
Second Line :
City : CARMEL
State : IN
Zip : 46074-8379
Country : US
Telephone Number : 612-270-1349
Fax Number :
Provider Business Practice Location Address
First Line : 3705 KENTUCKY AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46221-2703
Country : US
Telephone Number : 317-856-1253
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2020
Last Update Date : 12/02/2020

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Directions to “ SRINIVAS SAMBARAJU ” Practice Location

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