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General NPI Number Information
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NPI Number | 1912918574
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Entity Type | Individual
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Provider Name | SRINIVAS C. CHEVURU M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 2400 GREATSTONE PT FL 2
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City | LEXINGTON
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State | KY
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Zip | 40504-3274
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Country | US
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Telephone | 859-323-6211
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Fax | 859-257-7706
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Provider Business Mailing Address
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Address Line | 236 W MAIN ST
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City | MOUNT STERLING
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State | KY
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Zip | 40353-1348
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Country | US
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Telephone | 859-404-7686
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Fax | 859-498-8160
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 37888
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 37888
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License Number State | KY
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