MOHAN MALLIKARJUNA EDUPUGANTI (NPI# 1164737490) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164737490 |
| Entity Type | Individual |
| Full Name | MOHAN MALLIKARJUNA EDUPUGANTI |
| Other Name | MALLIK EDUPUGANTI |
| Credential | M.D. |
| Practice Address |
901 Patients First Dr Ste 2500 Washington MO 63090 |
| Mailing Address |
901 Patients First Dr Ste 2500 Washington MO 63090-4700 |
| Practice Telephone | 6362392711 |
| Mailing Telephone | 6362392711 |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2019-02-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
2018042912 | MO | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
E9506 | AR | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 840 Montclair Rd, Suite 340, Birmingham, AL 352131920 | 2055925135 |
| Street Address |
901 PATIENTS FIRST DR STE 2500 |
| City | WASHINGTON |
| State | MO |
| Zip Code | 63090 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205337441 | Kristin Louise Fisher | Nurse Practitioner | 901 Patients First Dr Ste 2500, Washington, MO 63090-4700 | 2018-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831798792 | Alicia Caroline Baker | Nurse Practitioner | 1070 W 7th St, Washington, MO 63090 | 2020-10-21 |
| 1962975839 | Jennifer Biermann | Pharmacist | 801 E 5th Street, Washington, MO 63090 | 2019-01-03 |
| 1487199733 | Kristen Elaine Cleavelin | Registered Nurse | Mercy Convenient Care, 901 Patients First Drive, Washington, MO 63090 | 2016-12-22 |
| 1699146712 | Washington Community Counseling Center | Community/Behavioral Health | 421 W. 5th Street, Suite 110, Washington, MO 63090 | 2015-10-15 |
| 1598002024 | Americare At Vicotrian Manor of Washington, LLC | Assisted Living Facility | 2701 Rabbit Trail Dr, Washington, MO 63090 | 2013-01-03 |
| 1578824116 | Rhonda Ann Pepmiller | Nurse Practitioner | 851 E 5th St Ste 309, Washington, MO 63090 | 2012-05-30 |
| 1932486032 | Julie Joanne Lynch | Pharmacist | 890 Country Corners, Washington, MO 63090 | 2011-11-03 |
| 1043590839 | Laurie Elizabeth Bryson | Counselor | 102 Elm Street, Suite 204, Washington, MO 63090 | 2011-08-24 |
| 1154640225 | Nicholas W Frederickson | Internal Medicine | 901 Patients First Drive Suite 3300, Washington, MO 63090 | 2010-05-27 |
| 1487889390 | Tracie Adele Miles | Counselor | 426 E. 5th St., 3rd Floor, Washington, MO 63090 | 2009-05-20 |
| Find all providers in zip 63090 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366905366 | Chava Chezar-azerrad | Internal Medicine | 110 Irving St Nw Ste 4b1, Washington, DC 20010-3017 | 2019-04-08 |
| 1902213150 | Edward Koifman | Internal Medicine | 110 Irving St Nw, Washington, DC 20010-3017 | 2014-07-21 |
| 1609913045 | Ramesh Mazhari | Internal Medicine | 2150 Pennsylvania Ave Nw, Washington, DC 20037-3201 | 2007-02-01 |
| 1376593756 | Washington Cardiology Center | Internal Medicine | 110 Irving St Nw, Room # 4b-1, Washington, DC 20010-2976 | 2006-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275032286 | Cardiac Cin of Kansas City LLC | Internal Medicine | 111 W 10th St Ste 103, Kansas City, MO 64105-1700 | 2018-02-05 |
| 1437658440 | Cardiac Cin of St Louis LLC | Internal Medicine | 11628 Old Ballas Rd # 346, Saint Louis, MO 63141-7030 | 2018-02-05 |
| 1629366984 | Jorge Marcelo Ramirez Romero | Internal Medicine | 1402 S. Grand, Fdt 14th Floor, St. Louis, MO 63104 | 2011-07-20 |
| 1285945295 | Byungsoo Ko | Internal Medicine | 100 Mercy Way Ste 320, Joplin, MO 64804-4524 | 2010-06-24 |
| 1033370358 | Shamail S. Tariq | Internal Medicine | 1071 Airport Rd, Festus, MO 63028-4103 | 2008-06-19 |
| 1104083351 | Cardiovascular Institute of Jacksonville P A | Internal Medicine | 1406 Ridgetree Trails Dr, Wildwood, MO 63021-5930 | 2008-05-16 |
| 1053401422 | Gus Theodos | Internal Medicine | 710 S Price Rd, Saint Louis, MO 63124-1867 | 2006-10-13 |
| 1225134117 | William R Reilly Inc | Internal Medicine | 450 N. New Ballas Rd, Ste 170w, St. Louis, MO 63141-6835 | 2006-09-16 |
| 1881799336 | Morton R. Rinder | Internal Medicine | 222 S Woods Mill Rd Ste 560, Chesterfield, MO 63017-3625 | 2006-09-13 |
| 1902834625 | Skaggs Community Hospital Association | Internal Medicine | 1150 State Hwy 248, Branson, MO 65616-2075 | 2006-06-29 |
| Find all providers with the same taxonomy | ||||
| City | WASHINGTON |
| Zip Code | 63090 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.