Provider Demographics
NPI:1669409629
Name:PUPPALA, RAMANA KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:RAMANA
Middle Name:KUMAR
Last Name:PUPPALA
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 1:300 N COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36037-2025
Mailing Address - Country:US
Mailing Address - Phone:334-382-1015
Mailing Address - Fax:334-382-1039
Practice Address - Street 1:300 N COLLEGE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:AL
Practice Address - Zip Code:36037-2025
Practice Address - Country:US
Practice Address - Phone:334-382-1015
Practice Address - Fax:334-382-1039
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036110928207VG0400X
GA70896207VG0400X
AL29509207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1669409629 / 112701Medicaid
IL036110928Medicaid
AL510-48849OtherBCBS
IL036110928Medicaid
AL102I160339Medicare PIN
AL510-48849OtherBCBS