Provider Demographics
NPI:1710181367
Name:ATLURI, PRATHA T (MD)
Entity Type:Individual
Prefix:DR
First Name:PRATHA
Middle Name:T
Last Name:ATLURI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9050 MONTGOMERY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-7740
Mailing Address - Country:US
Mailing Address - Phone:513-793-6100
Mailing Address - Fax:513-793-6101
Practice Address - Street 1:9050 MONTGOMERY RD
Practice Address - Street 2:SUITE A
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-7740
Practice Address - Country:US
Practice Address - Phone:513-793-6100
Practice Address - Fax:513-793-6101
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35076581207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH52808Medicare UPIN