Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 01058090A | IN |
N | 207YS0123X | Facial Plastic Surgeon | 01058090 | IN |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 01058090 | IN |
NPI | 1558316588 |
---|---|
Provider Name | Dr. Sreekant Cherukuri |
First Address | Merrillville, IN 46410-6267 |
Second Address | Merrillville, IN 46410-6267 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 08/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200455040 | (05) | IN |
H95273 | (02) | IN |