Individual
DR. YAMUNA KASARANENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1001 N MADISON AVE, GREENWOOD, IN 46142-4135
(317) 528-7500
(317) 528-7515
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01065616A
IN
207Q00000X
Family Medicine Physician
42867
KY
207Q00000X
Family Medicine Physician
MD26061
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104699
SIHO
—
01
—
200959360
MEDICAID- NORTON IMMEDIATE CARE CENTERS
IN
01
—
614355
NICC/ANTHEM
—
Enumeration date
07/01/2006
Last updated
05/01/2023
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