Kondamuri, Shanu

Kondamuri, Shanu is an individual health care provider with primary practice located at 8840 Calumet Ave Suite 103, Munster IN 46321-2545. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Pain Medicine, which is considered as his primary health care specialty. Kondamuri, Shanu can be contacted via phone (219) 836-7246.

Contact Information

Primary practice address
8840 Calumet Ave Suite 103 Munster IN 46321-2545
Phone: (219) 836-7246
Fax: (219) 836-6454
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 01045126A Indiana

Profile Details

NPI number 1497754287
LBN Legal business name Kondamuri, Shanu
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Dec 15th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497754287 NPPES
Illinois Other 01045126A BCBS OF ILLINOIS
Illinois Other 01045126A BCBS OF ILLINOIS
Illinois MEDICAID 200111560A BCBS OF ILLINOIS
Illinois Other 050043847 BCBS OF ILLINOIS
Illinois Other 000000330844 BCBS OF ILLINOIS

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