Provider Demographics
NPI:1336394576
Name:SARIPALLI, PAVIKA (MD)
Entity type:Individual
Prefix:
First Name:PAVIKA
Middle Name:
Last Name:SARIPALLI
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 1:1200 SCHWEGLER DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66045-7558
Mailing Address - Country:US
Mailing Address - Phone:785-864-9500
Mailing Address - Fax:
Practice Address - Street 1:1200 SCHWEGLER DR
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66045-7558
Practice Address - Country:US
Practice Address - Phone:785-864-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-28536207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSG49284Medicare UPIN