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Individual

KRISHNA MOHAN NAMBURI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1429 N 6TH ST, TERRE HAUTE, IN 47807-1037
(812) 242-3175
(812) 242-3543
Mailing address
221 S 6TH ST, TERRE HAUTE, IN 47807-4214
(812) 242-3175
(812) 242-3543

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01038133A
IN
207RC0000X
Cardiovascular Disease Physician
36077615
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000089624
ANTHEM
01
060023841
RAILROAD MCARE PALAMETTO
01
060068542
RAILROAD MEDICARE
IN
05
100376520
IN
01
100376520A
MOLINA HEALTHCARE MCAID
IN
01
100376520G
MOLINA HEALTHCARE MCAID
IN
05
100376520Y
IN
05
100376520Z
IN
01
351904269124
CARESOURCE MEDICAID
01
351904269237
CARESOURCE MEDICAID
01
4589941
AETNA
01
P00398470
RAILROAD MEDICARE
01
P00844276
RAILROAD MEDICARE
IN
01
P01056435
RAILROAD MEDICARE
IL
Enumeration date
08/30/2006
Last updated
11/10/2014
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