Individual
SOUBHAGYALAKSHMI PARVATHANENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1900 S NATIONAL AVE, SUITE 3600, SPRINGFIELD, MO 65804-2265
(417) 820-3911
(417) 820-3924
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35084650
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207478405
—
MO
05
—
2521033
—
OH
01
—
P00164228
RR MEDICARE
—
01
—
P00428673
RR MEDICARE #
MO
Enumeration date
04/10/2006
Last updated
02/05/2008
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