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NPI Code Detail

MEDICARE: SRIDEVI DAMERA

MEDICARE: SRIDEVI DAMERA
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
1207Q00000XFamily Medicine Physician01059476AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00297544OTHERINRR MEDICARE
2P00942802OTHERINMEDICARE RR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3000000376808OTHERINANTHEM
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932114774
Entity Type Code : Individual
Provider Name (Legal Business Name) : SRIDEVI DAMERA
Provider Business Mailing Address
First Line : 6626 E 75TH ST STE 500
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-2890
Country : US
Telephone Number : 317-355-2800
Fax Number : 317-355-2828
Provider Business Practice Location Address
First Line : 7910 E WASHINGTON ST STE 200
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-5563
Country : US
Telephone Number : 317-355-7171
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2006
Last Update Date : 01/05/2026

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Directions to “ SRIDEVI DAMERA ” Practice Location

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