Provider Demographics
NPI:1659491561
Name:EREN AND ATLURI, MDS,LLC
Entity Type:Organization
Organization Name:EREN AND ATLURI, MDS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SRIDHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ATLURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-799-5916
Mailing Address - Street 1:PO BOX 96
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-0096
Mailing Address - Country:US
Mailing Address - Phone:800-799-5916
Mailing Address - Fax:410-309-0113
Practice Address - Street 1:8109 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-6917
Practice Address - Country:US
Practice Address - Phone:410-768-3936
Practice Address - Fax:410-766-6683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD920900000Medicaid
MD244700200Medicaid
MDH13794Medicare UPIN
MD040N885FMedicare ID - Type Unspecified
MD244700200Medicaid
MD920900000Medicaid