Individual
SHANU KONDAMURI
Active
Individual
SHANU KONDAMURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
01045126A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000330844
BLUE CROSS BLUE SHIELD
IN
01
—
01045126A
BCBS OF ILLINOIS
IL
01
—
01045126A
LICENSE NUMBER
IN
01
—
050043847
MEDICARE RAILROAD
GA
05
—
200111560A
—
IN
Enumeration date
07/14/2005
Last updated
12/15/2011
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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