Provider Demographics
NPI:1063507531
Name:ATLURI, RAMA BANDLAMUDI (MD)
Entity Type:Individual
Prefix:
First Name:RAMA
Middle Name:BANDLAMUDI
Last Name:ATLURI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1402 S GRAND BLVD RM R213A
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-1004
Mailing Address - Country:US
Mailing Address - Phone:314-977-8836
Mailing Address - Fax:314-977-6777
Practice Address - Street 1:1225 S GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1016
Practice Address - Country:US
Practice Address - Phone:314-977-8836
Practice Address - Fax:314-977-8818
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO103401207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205278310Medicaid
MO301010247Medicare ID - Type Unspecified
H42927Medicare UPIN