Provider Demographics
NPI:1598704959
Name:VANGURI, APPARAO NV (MD)
Entity Type:Individual
Prefix:DR
First Name:APPARAO
Middle Name:NV
Last Name:VANGURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 STEMMERS RUN RD STE F
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21221-3361
Mailing Address - Country:US
Mailing Address - Phone:443-226-9933
Mailing Address - Fax:443-226-9933
Practice Address - Street 1:8872 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-2401
Practice Address - Country:US
Practice Address - Phone:410-529-7500
Practice Address - Fax:410-529-7510
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD19691174400000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD769791100Medicaid
MD769791100Medicaid
MD8730Medicare ID - Type Unspecified
MD3669900OtherBLUE CROSS BLUE SHIELD
MD8730Medicare ID - Type Unspecified