Provider Demographics
NPI:1538229901
Name:SRIPAL, HUNGI P (MD)
Entity type:Individual
Prefix:DR
First Name:HUNGI
Middle Name:P
Last Name:SRIPAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1010 W COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-2902
Mailing Address - Country:US
Mailing Address - Phone:573-218-6792
Mailing Address - Fax:573-218-6703
Practice Address - Street 1:1010 W COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-2902
Practice Address - Country:US
Practice Address - Phone:573-218-6792
Practice Address - Fax:573-218-6703
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6G49207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOR6G49OtherMO PROF. LICENSE
MOR6G49OtherMO PROF. LICENSE