Provider Demographics
NPI:1093821027
Name:VELURY, SRIHARSHA (MD)
Entity Type:Individual
Prefix:
First Name:SRIHARSHA
Middle Name:
Last Name:VELURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2379
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-2379
Mailing Address - Country:US
Mailing Address - Phone:606-408-6200
Mailing Address - Fax:606-408-6612
Practice Address - Street 1:2001 SCIOTO TRL STE 200
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-5122
Practice Address - Country:US
Practice Address - Phone:740-353-8100
Practice Address - Fax:740-353-8908
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY32164207RC0000X
OH35.073565207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY060069739OtherRAILROAD
OH060067518OtherRAILROAD
OHP00716515OtherMEDICARE RAILROAD
OH0279827Medicaid
KY642321649Medicaid
KY000000225945OtherBLUE CROSS
KYP00704452OtherMEDICARE RAILROAD
OH0279827Medicaid
KY642321649Medicaid
OHH262072Medicare PIN
OHH262070Medicare PIN
KY3312067Medicare PIN
OH0879095Medicare PIN
OHVE0879097Medicare PIN
KY00788021Medicare PIN