Individual
SIVA PRASAD JAGARLAPUDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
29097
IA
207RN0300X
Nephrology Physician
Primary
29097
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770533952
WELLMARK BCBS
IA
05
—
1770533952
—
IA
01
—
P00329641
RAILROAD MEDICARE
IA
Enumeration date
05/11/2006
Last updated
01/06/2015
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