Provider Demographics
NPI:1134155641
Name:VANKINENI, REKHA (MD)
Entity type:Individual
Prefix:
First Name:REKHA
Middle Name:
Last Name:VANKINENI
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 1:420 LOWELL DR SE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3754
Mailing Address - Country:US
Mailing Address - Phone:256-704-3571
Mailing Address - Fax:256-704-3572
Practice Address - Street 1:420 LOWELL DR SE
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3754
Practice Address - Country:US
Practice Address - Phone:256-704-3571
Practice Address - Fax:256-704-3572
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-25
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11124207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051002193OtherBCBS
AL051002193OtherBCBS
C74255Medicare UPIN