Provider Demographics
NPI:1316079262
Name:CHERUKURI, SULOCHANA DEVI (MD)
Entity type:Individual
Prefix:
First Name:SULOCHANA
Middle Name:DEVI
Last Name:CHERUKURI
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 1:5 RICHLAND MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6863
Mailing Address - Country:US
Mailing Address - Phone:803-540-1000
Mailing Address - Fax:803-540-1050
Practice Address - Street 1:BRODY 3E127
Practice Address - Street 2:600 MOYE BLVD
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-6863
Practice Address - Country:US
Practice Address - Phone:252-744-3326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27862207R00000X
NC2009-00444207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC278620Medicaid
SC278620Medicaid