Provider Demographics
NPI:1417134735
Name:SARAT K DONEPUDI MD APMC
Entity Type:Organization
Organization Name:SARAT K DONEPUDI MD APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAT
Authorized Official - Middle Name:K
Authorized Official - Last Name:DONEPUDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-265-3013
Mailing Address - Street 1:21420 HIGHWAY 20 WEST
Mailing Address - Street 2:
Mailing Address - City:VACHERIE
Mailing Address - State:LA
Mailing Address - Zip Code:70090-3614
Mailing Address - Country:US
Mailing Address - Phone:225-265-3013
Mailing Address - Fax:225-265-3775
Practice Address - Street 1:21420 HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:VACHERIE
Practice Address - State:LA
Practice Address - Zip Code:70090-3614
Practice Address - Country:US
Practice Address - Phone:225-265-3013
Practice Address - Fax:225-265-3775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04727R261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1197530Medicaid
1036692OtherMEDICAID GROUP
LAD79356Medicare UPIN
LA1197530Medicaid