Provider Demographics
NPI:1225244338
Name:AMANCHERLA, KIRANMAYI (MD)
Entity Type:Individual
Prefix:
First Name:KIRANMAYI
Middle Name:
Last Name:AMANCHERLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KIRANMAYI
Other - Middle Name:
Other - Last Name:AMANCHERLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:841 RIVER CREST CT # K-3
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-3248
Mailing Address - Country:US
Mailing Address - Phone:502-432-7026
Mailing Address - Fax:
Practice Address - Street 1:841 RIVER CREST CT # K-3
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-3248
Practice Address - Country:US
Practice Address - Phone:502-432-7026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program