Provider Demographics
NPI:1942312079
Name:SARMA, NARASIMHULU R (MD)
Entity Type:Individual
Prefix:DR
First Name:NARASIMHULU
Middle Name:R
Last Name:SARMA
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 1:923 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62703-2401
Mailing Address - Country:US
Mailing Address - Phone:217-788-9999
Mailing Address - Fax:217-788-9976
Practice Address - Street 1:923 S 6TH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62703-2401
Practice Address - Country:US
Practice Address - Phone:217-788-9999
Practice Address - Fax:217-788-9976
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360754982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036075498Medicaid
ILHEALTHLINKOther118064
IL093972OtherHEALTH ALLIANCE
ILP00159380OtherRAILROAD MEDICARE
ILP00159380OtherRAILROAD MEDICARE
ILK10209Medicare ID - Type UnspecifiedPROVIDER NUMBER