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Individual

SREENADHA RAO DAVULURI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
105 FAR WEST DRIVE, SUITE 201, ST JOSEPH, MO 64506-3511
(816) 271-8182
(816) 271-8183
Mailing address
105 FAR WEST DRIVE, SUITE 201, ST JOSEPH, MO 64506-3511
(816) 271-8182
(816) 271-8183

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
0419788
KS
2084N0400X
Neurology Physician
Primary
MDR6C71
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100123200C
KS
01
130019587
RR MEDIACRE
MO
05
1487713798
MO
Enumeration date
12/06/2006
Last updated
09/19/2017
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