MEDICARE: DR. ROOP KAMAL KOLLIPARA 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	207K00000X	Allergy & Immunology Physician	35041819	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1972560118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROOP KAMAL KOLLIPARA MD

Provider Business Mailing Address
First Line	:	540 PARMALEE AVE STE 410
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44510-1605
Country	:	US
Telephone Number	:	330-707-4553
Fax Number	:	330-707-4560

Provider Business Practice Location Address
First Line	:	540 PARMALEE AVE
Second Line	:	#410
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44510-1605
Country	:	US
Telephone Number	:	330-707-4553
Fax Number	:	330-707-4560

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

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	10/27/2022

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