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General NPI Number Information
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NPI Number | 1588658116
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Entity Type | Individual
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Provider Name | RADHIKA C CHERUKURI MD
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Gender | Female
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Dates
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Enumeration Date | 09/09/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 178 DOUGLAS PKWY SHELBY VALLEY CLINIC
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City | PIKEVILLE
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State | KY
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Zip | 41501-6970
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Country | US
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Telephone | 606-639-3135
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Fax | 606-639-3136
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Provider Business Mailing Address
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Address Line | 1709 KY ROUTE 321 STE 3 BIG SANDY HEALTH CARE INC
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City | PRESTONSBURG
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State | KY
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Zip | 41653-9101
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Country | US
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Telephone | 606-886-8546
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Fax | 606-886-8548
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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 | 37725
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License Number State | KY
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