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NPI Code Detail

MEDICARE: DR. PRAKASAM KALLURI MD

MEDICARE: DR. PRAKASAM KALLURI 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
1207X00000XOrthopaedic Surgery Physician0101237849VA
2207XS0117XOrthopaedic Surgery of the Spine Physician0101237849VA

General Provider Information

NPI Number : 1558365445
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PRAKASAM KALLURI MD
Provider Business Mailing Address
First Line : 815 W POYTHRESS ST
Second Line :
City : HOPEWELL
State : VA
Zip : 23860-2532
Country : US
Telephone Number : 804-471-7730
Fax Number : 804-471-7731
Provider Business Practice Location Address
First Line : 815 W POYTHRESS ST
Second Line :
City : HOPEWELL
State : VA
Zip : 23860-2532
Country : US
Telephone Number : 804-471-7730
Fax Number : 804-471-7731
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2005
Last Update Date : 11/22/2024

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Directions to “ DR. PRAKASAM KALLURI MD” Practice Location

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