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General NPI Number Information
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NPI Number | 1467004366
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Entity Type | Individual
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Provider Name | SHWETHA RUPENDU
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Gender | Female
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Dates
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Enumeration Date | 07/10/2019
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 2460 CURTIS ELLIS DR
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-2237
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Country | US
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Telephone | 828-456-7311
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Fax | 252-962-3320
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Provider Business Mailing Address
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Address Line | 507 MAIN STREET, APT 406,
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City | WORCESTER
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State | MA
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Zip | 01608
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Country | US
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Telephone | 508-868-7894
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 280186
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License Number State | MA
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