Provider Demographics
NPI:1104974658
Name:PALAKURTHY, UMA RAO (MD)
Entity type:Individual
Prefix:
First Name:UMA
Middle Name:RAO
Last Name:PALAKURTHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2353 SE 14TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50320-1109
Mailing Address - Country:US
Mailing Address - Phone:515-248-1400
Mailing Address - Fax:515-248-1440
Practice Address - Street 1:2353 SE 14TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50320-1109
Practice Address - Country:US
Practice Address - Phone:515-248-1400
Practice Address - Fax:515-248-1440
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA26153207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAC74086Medicare UPIN