Provider Demographics
NPI:1376508580
Name:MALEPATI, DURGA (MD)
Entity Type:Individual
Prefix:DR
First Name:DURGA
Middle Name:
Last Name:MALEPATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KANAKADURGA
Other - Middle Name:
Other - Last Name:NARRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:323 MCKEAN AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-1416
Mailing Address - Country:US
Mailing Address - Phone:724-489-9004
Mailing Address - Fax:
Practice Address - Street 1:323 MCKEAN AVE
Practice Address - Street 2:
Practice Address - City:CHARLEROI
Practice Address - State:PA
Practice Address - Zip Code:15022-1416
Practice Address - Country:US
Practice Address - Phone:724-489-9004
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD034758-E2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC33746Medicare UPIN