Provider Demographics
NPI:1992064836
Name:KANURY, AMALA (MD)
Entity type:Individual
Prefix:
First Name:AMALA
Middle Name:
Last Name:KANURY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMALA
Other - Middle Name:
Other - Last Name:TALASILA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:575 COAL VALLEY RD STE 204
Mailing Address - Street 2:
Mailing Address - City:CLAIRTON
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3724
Mailing Address - Country:US
Mailing Address - Phone:412-466-2220
Mailing Address - Fax:412-466-4048
Practice Address - Street 1:160 WAYLAND SMITH DR STE 102
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-7500
Practice Address - Country:US
Practice Address - Phone:724-438-3300
Practice Address - Fax:724-438-3366
Is Sole Proprietor?:No
Enumeration Date:2012-05-13
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK131352207RN0300X
PAMD487344207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA104411544-0001Medicaid