Anuradha Kollipara, Md | |
7972 West Jefferson Blvd Suite A Fort Wayne IN 46804-4140 | |
(260) 459-1780 | |
(260) 459-2779 |
Full Name | Anuradha Kollipara, Md |
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Speciality | Internal Medicine |
Location | 7972 West Jefferson Blvd, Fort Wayne, Indiana |
Authorized Official Name and Position | Anuradha Kollipara (OWNER) |
Authorized Official Contact | 2604591780 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Anuradha Kollipara, Md 7972 West Jefferson Blvd Suite A Fort Wayne IN 46804-4140 Ph: (260) 459-1780 | Anuradha Kollipara, Md 7972 West Jefferson Blvd Suite A Fort Wayne IN 46804-4140 Ph: (260) 459-1780 |
NPI Number | 1609019900 |
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Provider Enumeration Date | 04/16/2009 |
Last Update Date | 03/30/2017 |
Medicare PECOS PAC ID | 8325195944 |
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Medicare Enrollment ID | O20090416000180 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609019900 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 01046950 (Indiana) | Primary |
Provider Name | Yogeshchandra M Amin |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1639154115 PECOS PAC ID: 2466535265 Enrollment ID: I20080218000415 |
Provider Name | Anuradha Kollipara |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1871523787 PECOS PAC ID: 9335296193 Enrollment ID: I20090414000017 |
Provider Name | Subhash K Reddy |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1821068511 PECOS PAC ID: 1254488620 Enrollment ID: I20090422000410 |
Provider Name | Melissa Sue Skinner |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831735539 PECOS PAC ID: 3476989559 Enrollment ID: I20200210000272 |
Provider Name | Olufunke Patience Momoh |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750041216 PECOS PAC ID: 4284021171 Enrollment ID: I20220422001975 |
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