Provider Demographics
NPI:1427058551
Name:UPPULURI, ARUNA (MD)
Entity type:Individual
Prefix:
First Name:ARUNA
Middle Name:
Last Name:UPPULURI
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 1:9660 WICKER AVENUE
Mailing Address - Street 2:
Mailing Address - City:ST JOHN
Mailing Address - State:IN
Mailing Address - Zip Code:46373-9487
Mailing Address - Country:US
Mailing Address - Phone:219-365-1166
Mailing Address - Fax:219-226-2287
Practice Address - Street 1:9100 COLUMBIA AVENUE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2907
Practice Address - Country:US
Practice Address - Phone:219-836-5040
Practice Address - Fax:219-836-6835
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059101A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200175190Medicaid
IN6299905Medicare ID - Type Unspecified
INI17051Medicare UPIN
I17051Medicare UPIN