1023454527 NPI number — DR. RADHIKA THAPPETA M.D.

Table of content: DR. RADHIKA THAPPETA M.D. (NPI 1023454527)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023454527 NPI number — DR. RADHIKA THAPPETA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THAPPETA
Provider First Name:
RADHIKA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RACHAMALLU
Provider Other First Name:
RADHIKA
Provider Other Middle Name:
REDDY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1023454527
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
158 PHASE ONE ADARSH PALM MEADOWS
Provider Second Line Business Mailing Address:
RAMAGUNDANAHALLI
Provider Business Mailing Address City Name:
BANGALORE
Provider Business Mailing Address State Name:
KARNATAKA
Provider Business Mailing Address Postal Code:
560066
Provider Business Mailing Address Country Code:
IN
Provider Business Mailing Address Telephone Number:
14435527281
Provider Business Mailing Address Fax Number:
17073564172

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
158 PHASE ONE ADARSH PALM MEADOWS
Provider Second Line Business Practice Location Address:
RAMAGUNDANAHALLI
Provider Business Practice Location Address City Name:
BANGALORE
Provider Business Practice Location Address State Name:
KARNATAKA
Provider Business Practice Location Address Postal Code:
560066
Provider Business Practice Location Address Country Code:
IN
Provider Business Practice Location Address Telephone Number:
14435527281
Provider Business Practice Location Address Fax Number:
17073564172
Provider Enumeration Date:
05/12/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  052125 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208M00000X , with the licence number: 52125 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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