Provider Demographics
NPI:1447662911
Name:NADELLA, SHRAVAN (DO)
Entity type:Individual
Prefix:
First Name:SHRAVAN
Middle Name:
Last Name:NADELLA
Suffix:
Gender:M
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:KUMC INTERNAL MEDICINE RESIDENCY
Mailing Address - Street 2:3901 RAINBOW BLVD MS 2027
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-0001
Mailing Address - Country:US
Mailing Address - Phone:913-588-3974
Mailing Address - Fax:913-588-0593
Practice Address - Street 1:KUMC INTERNAL MEDICINE RESIDENCY
Practice Address - Street 2:3901 RAINBOW BLVD MS 2027
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:913-588-3974
Practice Address - Fax:913-588-0593
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-02
Last Update Date:2015-07-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS9408421207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine