Basic Information
| Provider Information | |||||||||
| NPI: | 1023120532 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SASIKALA & KOTESWARA RAO VEMURI MD PC | ||||||||
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| OtherOrganizationName: | S & K VEMURI, M.D. P.C. | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1397 S LINDEN RD | ||||||||
| Address2: | SUITE A | ||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485324194 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8107209300 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1397 S LINDEN RD | ||||||||
| Address2: | SUITE A | ||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485324194 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8107209300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 09/13/2013 | ||||||||
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| AuthorizedOfficialLastName: | VEMURI | ||||||||
| AuthorizedOfficialFirstName: | SASIKALA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8107209300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RA0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Adolescent Medicine |
No ID Information.