Individual
SHIREESHA R VUPPALANCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7120 CLEARVISTA DR, SUITE 2100, INDIANAPOLIS, IN 46256-1621
(317) 621-5676
(317) 621-5678
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01056071A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200503410
—
IN
01
—
P01209640
RR MEDICARE PTAN
IN
Enumeration date
08/10/2005
Last updated
12/08/2014
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