Individual
ANU PRASAD VELLANKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
827 N PINE ST, GRAMERCY, LA 70052-3659
(225) 869-9200
(225) 869-9241
Mailing address
PO BOX 419, GRAMERCY, LA 70052-0419
(225) 869-9200
(225) 869-9241
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12855R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-01417
UNITED HEALTH CARE
LA
01
—
110215391
RAILROAD MEDICARE
LA
01
—
1448800
MEDICAID RURAL HEALTH
LA
01
—
1457621
MEDICAID RURAL HEALTH
LA
05
—
1559571
—
LA
01
—
193870
MEDICARE RURAL HEALTH
LA
01
—
193875
MEDICARE RURAL HEALTH
LA
01
—
5CE42
MEDICARE GROUP
LA
01
—
7110052
AETNA
LA
Enumeration date
10/31/2005
Last updated
09/21/2011
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