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1538555495

NPI Code Detail

MEDICARE: DR. NANDHINI MARUPUDI MD

MEDICARE: DR. NANDHINI MARUPUDI MD

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	207LP2900X	Pain Medicine (Anesthesiology) Physician	61020	AZ
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207L00000X	Anesthesiology Physician	61020	AZ
4	207LP2900X	Pain Medicine (Anesthesiology) Physician	036144500	IL

General Provider Information

NPI Number	:	1538555495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANDHINI MARUPUDI MD

Provider Business Mailing Address
First Line	:	1050 N EDGELAWN DR
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60506-1860
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4605 E ELWOOD ST STE 500
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85040-1978
Country	:	US
Telephone Number	:	602-200-9021
Fax Number	:	602-200-9087

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

Provider Enumeration Date	:	04/07/2015
Last Update Date	:	07/10/2023

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Directions to “ DR. NANDHINI MARUPUDI MD” Practice Location

Language	Start Address	Practice Location

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