Provider Demographics
NPI:1871631341
Name:SABAPATHI, ANURADHA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANURADHA
Middle Name:
Last Name:SABAPATHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5213 S ALSTON AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4430
Mailing Address - Country:US
Mailing Address - Phone:919-620-4467
Mailing Address - Fax:
Practice Address - Street 1:1821 HILLANDALE RD 24A
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2671
Practice Address - Country:US
Practice Address - Phone:919-620-5042
Practice Address - Fax:919-620-4921
Is Sole Proprietor?:No
Enumeration Date:2007-02-04
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR1232207Q00000X
NC2009-02039207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1871631341OtherHUMANA- NLPCC
KY000000564410OtherANTHEM- NLPCC
KY0042309OtherMEDICARE- NORTON LOUISVILLE PRIMARY CARE CENTER
KY6491381OtherCIGNA- NLPCC
KYP00743894OtherRAILROAD MEDICARE- NORTON LOUISVILLE PRIMARY CARE
KY096724OtherSIHO- NLPCC
KY7100071710Medicaid
KY3533018000OtherPASSPORT ADVANTAGE- NLPCC
KY50019980OtherPASSPORT- NORTON LOUISVILLE PRIMARY CARE CENTER