Healthcare Provider Details

I. General information

NPI: 1134357213
Provider Name (Legal Business Name): SAYURI CHERUVU M.B.,B.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2009
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 STATE ST STE 240
LA PORTE IN
46350-3112
US

IV. Provider business mailing address

1331 STATE ST STE 240
LA PORTE IN
46350-3112
US

V. Phone/Fax

Practice location:
  • Phone: 219-924-8178
  • Fax: 219-344-5159
Mailing address:
  • Phone: 219-924-8178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number01080364A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: