Provider Demographics
NPI:1518302249
Name:MULPURI, MADHAVI (MD)
Entity Type:Individual
Prefix:DR
First Name:MADHAVI
Middle Name:
Last Name:MULPURI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10515 W. SANTA FE DR
Mailing Address - Street 2:BANNER FAMILY GERIARTRIC FELLOWSHIP
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351
Mailing Address - Country:US
Mailing Address - Phone:623-334-5290
Mailing Address - Fax:
Practice Address - Street 1:10515 W. SANTA FE DR
Practice Address - Street 2:BANNER FAMILY GERIARTRIC FELLOWSHIP
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351
Practice Address - Country:US
Practice Address - Phone:623-334-5290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program