Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 0434165 | KS |
N | 207P00000X | Emergency Physician | 2006018690 | MO |
N | 207P00000X | Emergency Physician | 35929 | IA |
N | 207Q00000X | Family Doctor | 0434165 | KS |
Y | 207Q00000X | Family Doctor | 2006018690 | MO |
N | 207Q00000X | Family Doctor | 35929 | IA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 0434165 | KS |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 2006018690 | MO |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 35929 | IA |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 0434165 | KS |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 2006018690 | MO |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 35929 | IA |
NPI | 1326031006 |
---|---|
Provider Name | Mr. Shyam K. Akkulugari |
First Address | Overland Park, KS 66207-0612 |
Second Address | Overland Park, KS 66221-9748 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2005 |
Last Update Date | 07/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I29925 | (02) | MO |