Provider Demographics
NPI:1457478117
Name:RAPURI, SRINIVAS B (MD)
Entity Type:Individual
Prefix:DR
First Name:SRINIVAS
Middle Name:B
Last Name:RAPURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:230 LEXINGTON STREET
Mailing Address - Street 2:#D
Mailing Address - City:LANCASTER
Mailing Address - State:KY
Mailing Address - Zip Code:40444-1179
Mailing Address - Country:US
Mailing Address - Phone:859-304-5157
Mailing Address - Fax:859-304-5159
Practice Address - Street 1:230 LEXINGTON STREET
Practice Address - Street 2:D
Practice Address - City:LANCASTER
Practice Address - State:KY
Practice Address - Zip Code:40444-1179
Practice Address - Country:US
Practice Address - Phone:859-304-5157
Practice Address - Fax:859-304-5159
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT188156207Q00000X
KY43179207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100123200Medicaid
KY125794Medicare UPIN