Individual
DR. SRINATH TADAKAMALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
3001 E ELM ST, HARRISONVILLE, MO 64701
(816) 813-7027
(913) 674-5563
Mailing address
PO BOX 23085, OVERLAND PARK, KS 66283-3085
(816) 813-7027
(913) 674-5563
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2005025981
MO
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
2005025981
MO
208M00000X
Hospitalist Physician
2005025981
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207472903
—
MO
Enumeration date
03/07/2006
Last updated
03/07/2023
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