Individual
KAVITHA TALLAPANENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
615 S PRESTON ST, LOUISVILLE, KY 40202
(502) 852-5757
(502) 852-7643
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0330
(502) 588-0326
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34801
KY
207RN0300X
Nephrology Physician
Primary
34801
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000185262
ANTHEM
KY
05
—
300018420
—
IN
05
—
64062342
—
KY
01
—
K088322
MEDICARE
KY
Enumeration date
06/24/2005
Last updated
10/11/2018
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