Provider Demographics
NPI:1992840706
Name:SATISH C TALLURI, MD
Entity Type:Organization
Organization Name:SATISH C TALLURI, MD
Other - Org Name:APOLLO INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EVA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNZ
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:717-564-0564
Mailing Address - Street 1:121 N 32ND ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-1609
Mailing Address - Country:US
Mailing Address - Phone:717-564-0564
Mailing Address - Fax:717-564-3135
Practice Address - Street 1:200 HIDDEN HILL FARM LN
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-9360
Practice Address - Country:US
Practice Address - Phone:717-564-0564
Practice Address - Fax:717-564-3135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD064768L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC76063Medicare UPIN
PA012960Medicare PIN
PAP00066442Medicare PIN