Individual
THRESIAMMA A MUKKADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 MEDICAL VILLAGE DR, INDEPENDENT ANESTHESIOLOGISTS PSC, EDGEWOOD, KY 41017-3403
(859) 341-7246
(859) 341-7867
Mailing address
20 MEDICAL VILLAGE DR, SUITE 258, EDGEWOOD, KY 41017-5401
(859) 341-7246
(859) 341-7867
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
23917
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000032846
ANTHEM BLUE SHIELD
—
05
—
0302176
—
OH
01
—
10814461
CAQH
—
05
—
64239171
—
KY
Enumeration date
11/07/2005
Last updated
02/21/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us