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General NPI Number Information
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NPI Number | 1508483280
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Entity Type | Individual
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Provider Name | SREEVASTAV TEJA KALANGI MD
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Gender | Male
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Dates
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Enumeration Date | 06/29/2020
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 2710 SAINT FRANCIS DR STE 300
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City | WATERLOO
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State | IA
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Zip | 50702-5620
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Country | US
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Telephone | 319-272-5000
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Fax | 319-272-5470
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Provider Business Mailing Address
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Address Line | 3421 W 9TH ST MEDICAL AFFAIRS - PROVIDER ENROLLMENTS
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City | WATERLOO
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State | IA
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Zip | 50702-5401
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Country | US
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Telephone | 319-272-7304
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Fax | 319-272-7318
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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 | MD-53889
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MD-53889
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License Number State | IA
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