Organization
KOPPOLU P SARMA MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KOPPOLU P SARMA MD (PRESIDENT)
(219) 942-5745
Entity
Organization
Contact information
Practice address
300 W 61ST AVE, CENTER FOR IMAGING AND RADIATION, HOBART, IN 46342-6490
(219) 942-5745
Mailing address
DEPT 6076, CAROL STREAM, IL 60122
(219) 942-5745
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
01027669A
IN
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100213740A
—
IN
05
—
200008710A
—
IN
Enumeration date
05/27/2006
Last updated
10/26/2011
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