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NPI Code Detail

MEDICARE: SHIREESHA R VUPPALANCHI M.D.

MEDICARE: SHIREESHA R VUPPALANCHI M.D.
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
1207R00000XInternal Medicine Physician01056071AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P01209640OTHERINRR MEDICARE PTAN

Other Identifiers

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

General Provider Information

NPI Number : 1891796025
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIREESHA R VUPPALANCHI M.D.
Provider Business Mailing Address
First Line : 6626 E 75TH ST
Second Line : SUITE 500
City : INDIANAPOLIS
State : IN
Zip : 46250-2805
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7120 CLEARVISTA DR
Second Line : SUITE 2100
City : INDIANAPOLIS
State : IN
Zip : 46256-1621
Country : US
Telephone Number : 317-621-5676
Fax Number : 317-621-5678
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 12/08/2014

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Directions to “ SHIREESHA R VUPPALANCHI M.D.” Practice Location

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