Provider Demographics
NPI:1144544313
Name:SURAPANENI, SOWMYA LAKSHMI (MD)
Entity type:Individual
Prefix:DR
First Name:SOWMYA
Middle Name:LAKSHMI
Last Name:SURAPANENI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SOWMYA
Other - Middle Name:LAKSHMI
Other - Last Name:NALLURI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:500 UNIVERSITY DRIVE
Mailing Address - Street 2:C5840
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033
Mailing Address - Country:US
Mailing Address - Phone:717-531-5384
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:A410
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-631-6384
Practice Address - Fax:717-531-8274
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD442894207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology