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Individual

VENKATESWARA R KARUPARTHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2508 25TH ST STE D, ROCK ISLAND, IL 61201-5419
(309) 762-7246
(309) 762-7242
Mailing address
PO BOX 850, MOLINE, IL 61266-0850
(309) 762-9711
(309) 762-9747

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
34461
IA
207LP2900X
Pain Medicine (Anesthesiology) Physician
34461
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0258764
IA
01
08132073
BLUE SHIELD
IL
05
2258764
IA
01
44548
WELLMARK BCBS
IA
01
92920
BLUE SHIELD
IA
Enumeration date
09/28/2005
Last updated
01/04/2010
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