Provider Demographics
NPI:1902303522
Name:SANNAPANENI, SHILPA KALA (MD)
Entity type:Individual
Prefix:DR
First Name:SHILPA
Middle Name:KALA
Last Name:SANNAPANENI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHILPA
Other - Middle Name:KALA
Other - Last Name:SANNAPANENI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:801-357-0570
Mailing Address - Fax:
Practice Address - Street 1:395 W COUGAR BLVD STE 602
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3331
Practice Address - Country:US
Practice Address - Phone:801-357-0570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301508115208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist