| Premier Internal Medicine Llc | |
|
6275 E Broad St Columbus OH 43213-1504 | |
| (614) 824-3394 | |
| Not Available |
| Full Name | Premier Internal Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6275 E Broad St, Columbus, Ohio |
| Authorized Official Name and Position | Srinivas Anand Rao Ponneri (OFFICE MANAGER/DIRECTOR RCM) |
| Authorized Official Contact | 6143734202 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Internal Medicine Llc 6275 E Broad St Columbus OH 43213-1504 Ph: (614) 861-0967 | Premier Internal Medicine Llc 6275 E Broad St Columbus OH 43213-1504 Ph: (614) 824-3394 |
| NPI Number | 1790069698 |
|---|---|
| Provider Enumeration Date | 10/11/2011 |
| Last Update Date | 10/10/2022 |
| Medicare PECOS PAC ID | 1557521291 |
|---|---|
| Medicare Enrollment ID | O20120404000452 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790069698 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Alex T Alahakoon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073672531 PECOS PAC ID: 5890771778 Enrollment ID: I20040629001732 |
| Provider Name | Oshana V Alahakoon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285793745 PECOS PAC ID: 9436135316 Enrollment ID: I20040629001737 |
| Provider Name | Messeret Tewolde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114364668 PECOS PAC ID: 2567606023 Enrollment ID: I20130924000031 |
| Provider Name | Abhishake Kaapuraala |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841456316 PECOS PAC ID: 1658540018 Enrollment ID: I20161028000431 |
| Provider Name | Darian Kopp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023657442 PECOS PAC ID: 5799113569 Enrollment ID: I20200310002922 |
| Provider Name | Chaitanya Bukkapatnam |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1093208647 PECOS PAC ID: 8022365238 Enrollment ID: I20221104001769 |
| Provider Name | Misty Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295370054 PECOS PAC ID: 3274903935 Enrollment ID: I20221221002977 |
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