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Individual

SHREELATA R DURBHAKULA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7700
(216) 286-6341
Mailing address
3605 WARRENSVILLE CENTER RD, 1ST FL, MSC9152, SHAKER HEIGHTS, OH 44122-5203
(216) 286-6299
(216) 286-6341

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35-086395
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000221390
UNISON
OH
01
000000368504
ANTHEM
OH
01
000000525905
ANTHEM
OH
01
2546489
AETNA
OH
05
2567851
OH
Enumeration date
07/16/2006
Last updated
11/15/2007
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