Individual
DR. SHASHI K POLAVARAPU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1130 N J ST, RICHMOND, IN 47374-1913
(765) 983-3298
(765) 983-7970
Mailing address
1100 REID PKWY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 983-3050
(765) 983-7950
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01061114A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000730376
ANTHEM
IN
05
—
200800790
—
IN
Enumeration date
05/05/2006
Last updated
12/07/2021
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