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General NPI Number Information
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NPI Number | 1528292406
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Entity Type | Individual
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Provider Name | VENUMADHAV CHIRUNOMULA MD
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Gender | Male
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Dates
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Enumeration Date | 05/07/2009
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 1701 LACEY ST
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63701-5230
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Country | US
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Telephone | 573-334-4822
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 776084
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City | CHICAGO
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State | IL
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Zip | 60677-6084
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Country | US
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Telephone | 240-964-8564
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 2013020298
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License Number State | MO
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