Individual
DR. SREE K.P. MULPURU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
312 10TH ST, FAIRMONT, WV 26554-3611
(304) 366-2818
(304) 366-7614
Mailing address
312 10TH ST, FAIRMONT, WV 26554-3611
(304) 366-2818
(304) 366-7614
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
11598
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112060000
—
WV
Enumeration date
11/06/2006
Last updated
07/08/2007
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