Provider Demographics
NPI:1144481250
Name:VUPPALI, KALPANA (MD)
Entity type:Individual
Prefix:DR
First Name:KALPANA
Middle Name:
Last Name:VUPPALI
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:PO BOX 1111
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-0907
Mailing Address - Country:US
Mailing Address - Phone:215-453-4995
Mailing Address - Fax:215-453-4646
Practice Address - Street 1:700 LAWN AVE
Practice Address - Street 2:
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1548
Practice Address - Country:US
Practice Address - Phone:215-453-4139
Practice Address - Fax:215-453-4991
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD446932207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2744251OtherHIGHMARK BLUE SHIELD
PA9045807OtherAETNA
PA3887602000OtherINDEPENDENCE BLUE CROSS
TX287460401Medicaid
TX287460402Medicaid
TXTXB138740Medicare PIN
PA2744251OtherHIGHMARK BLUE SHIELD
TXTXB155529Medicare PIN
TX287460401Medicaid
TX287460402Medicaid