Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 01045226A | IN |
Y | 207RH0003X | Hematology & Oncology | 01045226A | IN |
N | 207RX0202X | Medical Oncology | 01045226A | IN |
NPI | 1336146372 |
---|---|
Provider Name | Karuna S Koneru |
First Address | Bloomington, IN 47402-1329 |
Second Address | Bloomington, IN 47403-2316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2005 |
Last Update Date | 17/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200002430 | (05) | IN |
F78347 | (02) |