Provider Demographics
NPI:1659353829
Name:ATLURI, SAIRAM L (MD)
Entity Type:Individual
Prefix:
First Name:SAIRAM
Middle Name:L
Last Name:ATLURI
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 1:7655 5 MILE RD STE 117
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-4326
Mailing Address - Country:US
Mailing Address - Phone:513-624-7525
Mailing Address - Fax:513-624-0578
Practice Address - Street 1:7655 5 MILE RD STE 117
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-4326
Practice Address - Country:US
Practice Address - Phone:513-624-7525
Practice Address - Fax:513-624-0578
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-15
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35068859A208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000350928OtherANTHEM BLUE SHIELD
KY64059264Medicaid
610168000OtherFEDERAL WORKERS COMP
10818917OtherCAQH
OH2044773Medicaid
5757645OtherAETNA
IN200377720Medicaid
352199392OtherBUREAU OF WORKERS COMP
IN200377720Medicaid
KYP01197518Medicare PIN
KYGROUP K036300Medicare PIN
G58791Medicare UPIN
OH2044773Medicaid
KYK036301Medicare PIN