Provider Demographics
NPI:1043521255
Name:THALLAPANENI, RAMBABU (MD)
Entity Type:Individual
Prefix:
First Name:RAMBABU
Middle Name:
Last Name:THALLAPANENI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:30 MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3955
Mailing Address - Country:US
Mailing Address - Phone:610-619-8590
Mailing Address - Fax:610-619-8591
Practice Address - Street 1:30 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE 404
Practice Address - City:UPLAND
Practice Address - State:PA
Practice Address - Zip Code:19013
Practice Address - Country:US
Practice Address - Phone:610-619-8590
Practice Address - Fax:610-619-8591
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD449490207Q00000X
PAMT198270207Q00000X
OH35.127213208M00000X
CAC177570208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine