Individual
DR. RAMABRAHMAM GULLAPALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 425-6030
(260) 425-6038
Mailing address
3702 NEW VISION DR BLDG B, FORT WAYNE, IN 46845-1703
(260) 266-6013
(260) 458-5831
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01047905A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000082075
ANTHEM BC/BS
IN
05
—
200160090
—
IN
01
—
8710
PHP
IN
Enumeration date
07/01/2005
Last updated
04/05/2018
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