Individual
SRI DIVYA MUPPALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2091 N BEND RD, HEBRON, HEBRON, KY 41048-9691
(859) 586-2200
(859) 586-4222
Mailing address
2300 CHAMBER CENTER DR, SUITE 200, LAKESIDE PARK, KY 41017-1673
(859) 344-5555
(859) 344-5552
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2007013992
MO
207R00000X
Internal Medicine Physician
Primary
44863
KY
Other
Enumeration date
06/26/2007
Last updated
09/13/2013
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