Provider Demographics
NPI:1689623852
Name:KARNAM, UMAPRASANNA S (MD)
Entity Type:Individual
Prefix:
First Name:UMAPRASANNA
Middle Name:S
Last Name:KARNAM
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 1:1543 W. 12600 S.
Mailing Address - Street 2:STE 102
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-7000
Mailing Address - Country:US
Mailing Address - Phone:801-563-5121
Mailing Address - Fax:801-566-3926
Practice Address - Street 1:1543 W. 12600 S.
Practice Address - Street 2:STE 102
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-7000
Practice Address - Country:US
Practice Address - Phone:801-563-5121
Practice Address - Fax:801-566-3926
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT50222851205207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT107011519101OtherIHC HEALTHPLANS
UT870281028000Medicaid
UTQM0000057554OtherALTIUS
UT100016596OtherPALMETTO GBA
UT29-00115OtherUNITED HEALTHCARE
UT744958OtherDMBA
UT870281028UMAOtherEMIA
UT68578OtherPEHP
UT29-00115OtherUNITED HEALTHCARE