Provider Demographics
NPI:1295857621
Name:MUNCIE ALLERGY CENTER. P.S.C.
Entity Type:Organization
Organization Name:MUNCIE ALLERGY CENTER. P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SAI
Authorized Official - Middle Name:R
Authorized Official - Last Name:KARLAPUDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-284-4050
Mailing Address - Street 1:4505 N WHEELING AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-1284
Mailing Address - Country:US
Mailing Address - Phone:765-284-4050
Mailing Address - Fax:765-294-9301
Practice Address - Street 1:4505 N WHEELING AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-1284
Practice Address - Country:US
Practice Address - Phone:765-284-4050
Practice Address - Fax:765-294-9301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-05
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01040366207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
209340Medicare ID - Type Unspecified
IND69470Medicare UPIN
INF44139Medicare UPIN
IN209340Medicare ID - Type Unspecified