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Individual
SRINIVASA R. TIRUMALAREDDY
Active
Individual
SRINIVASA R. TIRUMALAREDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD427298
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014433750001
—
PA
01
—
11551039
CAQH ID#
PA
01
—
1166904
AETNA HMO
PA
01
—
1783127
HIGHMARK BLUE SHIELD
PA
01
—
2620467000
IBC - PC/KHPE
PA
01
—
30027296
KEYSTONE MERCY
PA
01
—
7791748
AETNA PPO
PA
Enumeration date
05/18/2006
Last updated
10/15/2012
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