Healthcare Provider Details

I. General information

NPI: 1336146372
Provider Name (Legal Business Name): KARUNA S KONERU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2005
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 W 2ND ST
BLOOMINGTON IN
47403-2316
US

IV. Provider business mailing address

250 N SHADELAND AVE
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 812-676-4444
  • Fax: 812-676-4445
Mailing address:
  • Phone: 317-963-4171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number01045226A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number01045226A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number01045226A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: