Provider Demographics
NPI:1336251388
Name:KAKARLAPUDI, RAJ VERRABHADRA (MD)
Entity Type:Individual
Prefix:
First Name:RAJ
Middle Name:VERRABHADRA
Last Name:KAKARLAPUDI
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 1:77 W ELMWOOD DR STE 211
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4263
Mailing Address - Country:US
Mailing Address - Phone:937-000-0000
Mailing Address - Fax:937-000-0000
Practice Address - Street 1:10475 READING RD STE 115
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-2500
Practice Address - Country:US
Practice Address - Phone:513-000-0000
Practice Address - Fax:513-000-0000
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY43897207X00000X, 207XS0117X
OH35.096872207XS0117X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP400027044Medicare PIN