Individual
DR. ANURADHA KOLLIPARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
7972 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 436-0281
(260) 459-2779
Mailing address
7972 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 436-0281
(260) 459-2779
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01046950
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000093479
BLUE CROSS BLUE SHIELD
—
01
—
110212244
RAILROAD MEDICARE
—
05
—
200197730
—
IN
Enumeration date
07/04/2006
Last updated
01/10/2011
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