Individual
SIREESHA KOPPULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
UNM HOSPITALS, 2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106
(505) 272-4281
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
37291
AZ
207RN0300X
Nephrology Physician
37291
AZ
207RN0300X
Nephrology Physician
Primary
MD2020-0102
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
233952
—
AZ
01
—
P00447267
RAILROAD MEDICARE
AZ
Enumeration date
07/26/2007
Last updated
04/02/2025
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