MEDICARE: MR. SHYAM K. AKKULUGARI MD., MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	35929	IA
2	207P00000X	Emergency Medicine Physician	2006018690	MO
3	207P00000X	Emergency Medicine Physician	0434165	KS
4	207Q00000X	Family Medicine Physician	35929	IA
5	207Q00000X	Family Medicine Physician	0434165	KS
6	207QG0300X	Geriatric Medicine (Family Medicine) Physician	35929	IA
7	207QG0300X	Geriatric Medicine (Family Medicine) Physician	0434165	KS
8	207QG0300X	Geriatric Medicine (Family Medicine) Physician	2006018690	MO
9	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	0434165	KS
10	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	2006018690	MO
11	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	35929	IA
12	207Q00000X	Family Medicine Physician	2006018690	MO

General Provider Information

NPI Number	:	1326031006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SHYAM K. AKKULUGARI MD., MPH

Provider Business Mailing Address
First Line	:	PO BOX 7612
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66207-0612
Country	:	US
Telephone Number	:	913-271-8676
Fax Number	:	888-856-3199

Provider Business Practice Location Address
First Line	:	14540 SWITZER RD
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66221-9748
Country	:	US
Telephone Number	:	913-271-8676
Fax Number	:	888-856-3199

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	12/07/2020

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