Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | A124986 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | A124986 | CA |
NPI | 1053325050 |
---|---|
Provider Name | Dr. Sasikanth Adigopula |
First Address | Indianapolis, IN 46250-2890 |
Second Address | Indianapolis, IN 46250-2693 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 11/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
300031536 | (05) | IN |
A124986 | CALIFORNIA MEDICAL LICENSE NUMBER (01) | CA |