Provider Demographics
NPI:1154307536
Name:VEMURI, RAVI K (MD)
Entity Type:Individual
Prefix:DR
First Name:RAVI
Middle Name:K
Last Name:VEMURI
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 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-643-7900
Mailing Address - Fax:515-643-7901
Practice Address - Street 1:411 LAUREL ST STE A120
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3027
Practice Address - Country:US
Practice Address - Phone:515-643-7900
Practice Address - Fax:515-643-7901
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA28783207RI0200X, 2083P0011X
IAMD-28783207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA08460OtherWELLMARK
IA73011OtherCOVENTRY
IA0083253Medicaid
IA983822OtherUNITED HEALTHCARE
IAIA0119OtherUHC OF THE RIVER VALLEY
IA18753OtherMIDLAND'S CHOICE
F30311Medicare UPIN
IA983822OtherUNITED HEALTHCARE