Provider Demographics
NPI:1427074889
Name:DUTHULURU, SOWJANYA (MD)
Entity type:Individual
Prefix:DR
First Name:SOWJANYA
Middle Name:
Last Name:DUTHULURU
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 1:14959 OUTLOOK LN
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-2931
Mailing Address - Country:US
Mailing Address - Phone:408-205-4488
Mailing Address - Fax:785-354-6349
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-1301
Practice Address - Country:US
Practice Address - Phone:913-945-5753
Practice Address - Fax:913-588-4098
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-31996207RP1001X
KST-00689207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine