Provider Demographics
NPI:1114690278
Name:VUTHALURU, SRINEIL (MD)
Entity Type:Individual
Prefix:
First Name:SRINEIL
Middle Name:
Last Name:VUTHALURU
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 1:983280 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-3280
Mailing Address - Country:US
Mailing Address - Phone:402-559-5510
Mailing Address - Fax:408-559-6749
Practice Address - Street 1:983280 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-3280
Practice Address - Country:US
Practice Address - Phone:402-559-5510
Practice Address - Fax:408-559-6749
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program