Provider Demographics
NPI:1285742296
Name:KUNAPAREDDY, SURESH (MD)
Entity type:Individual
Prefix:
First Name:SURESH
Middle Name:
Last Name:KUNAPAREDDY
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 1:221 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47807-4214
Mailing Address - Country:US
Mailing Address - Phone:812-242-3610
Mailing Address - Fax:812-242-3630
Practice Address - Street 1:1711 N 6 1/2 ST
Practice Address - Street 2:STE 200
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-2766
Practice Address - Country:US
Practice Address - Phone:812-242-3610
Practice Address - Fax:812-242-3630
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01054210A207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000194279OtherANTHEM
900003738OtherRAILROAD MCARE PALAMETTO
INP00818718OtherRAILROAD MEDICARE
IN200333390Medicaid
IN200333390YMedicaid
IN265130UUMedicare PIN
IN130840OMedicare PIN
900003738OtherRAILROAD MCARE PALAMETTO
INP00818718OtherRAILROAD MEDICARE
IN780920ZMedicare PIN
G98481Medicare UPIN
IN859910SSSSMedicare PIN
IN301550RMedicare PIN
IN200333390YMedicaid
IN200333390Medicaid