Provider Demographics
NPI:1063512804
Name:VUPPALAPATI, DWARAKANATH (MD)
Entity type:Individual
Prefix:
First Name:DWARAKANATH
Middle Name:
Last Name:VUPPALAPATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1811
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89702-1811
Mailing Address - Country:US
Mailing Address - Phone:775-445-7354
Mailing Address - Fax:775-885-4795
Practice Address - Street 1:1080 N. MINNESOTA ST.
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703
Practice Address - Country:US
Practice Address - Phone:775-445-7354
Practice Address - Fax:775-888-6233
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV108042084P0015X, 2084P0800X, 2084P0802X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1005033741Medicaid
NV201286555Medicare UPIN
NVV39190Medicare ID - Type Unspecified