Healthcare Provider Details

I. General information

NPI: 1730429408
Provider Name (Legal Business Name): SANDEEP PULIMI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2013
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 5TH ST 801 FIFTH STREET
SIOUX CITY IA
51101-1326
US

IV. Provider business mailing address

8117 PRESTON RD
DALLAS TX
75225-6332
US

V. Phone/Fax

Practice location:
  • Phone: 712-279-5999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036134086
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number61434-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: