Provider Demographics
NPI:1447412788
Name:VALLURUPALLI, SANTARAM (MD)
Entity Type:Individual
Prefix:
First Name:SANTARAM
Middle Name:
Last Name:VALLURUPALLI
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:920 STANTON L YOUNG BLVD
Mailing Address - Street 2:SUITE WP 1380
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5036
Mailing Address - Country:US
Mailing Address - Phone:405-271-4426
Mailing Address - Fax:405-271-3074
Practice Address - Street 1:920 STANTON L YOUNG BLVD
Practice Address - Street 2:SUITE WP 1380
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5036
Practice Address - Country:US
Practice Address - Phone:405-271-4426
Practice Address - Fax:405-271-3074
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2008015178207X00000X
OH121194207XS0117X
OK30833207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH121194OtherSTATE BOARD OF OHIO
MO2008015178OtherMEDICAL LICENSE
OK30833OtherOKLAHOMA MEDICAL BOARD