Provider Demographics
NPI:1891756573
Name:DUVVURI, UMA (MD)
Entity Type:Individual
Prefix:DR
First Name:UMA
Middle Name:
Last Name:DUVVURI
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:PO BOX 4328
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07474-4328
Mailing Address - Country:US
Mailing Address - Phone:973-859-7277
Mailing Address - Fax:862-666-9215
Practice Address - Street 1:637 ROUTE 23 SOUTH
Practice Address - Street 2:
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444-1996
Practice Address - Country:US
Practice Address - Phone:973-859-7277
Practice Address - Fax:862-666-9215
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07363500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0035068Medicaid
NJ055651Medicare UPIN
NJH25153Medicare UPIN