SRINIVAS KONERU (NPI# 1477599587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477599587 |
| Entity Type | Individual |
| Full Name | SRINIVAS KONERU |
| Credential | MD |
| Practice Address |
11900 E 12 Mile Rd Suite 103 Warren MI 48093-3487 |
| Practice Telephone | 5865740890 |
| Practice Fax Number | 5865749321 |
| Mailing Telephone | 5865740890 |
| Mailing Fax Number | 5865749321 |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2011-02-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
4301080674 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 110E014810 | 01 | |
| BCN | 110E014810 | 01 | |
| CAPE | 136847 | 01 | |
| GREAT LAKES | 144732 | 01 | |
| OMNI | 921607 | 01 | |
| PALMETTO | P00012493 | 01 | |
| PREFERRED CHOICES | 136847 | 01 | |
| HAP | G58723 | 01 | |
| MI | 449652010 | 05 | |
| CARE CHOICES | 136847 | 01 | |
| MCARE | 16829 | 01 |
| Street Address |
11900 E 12 MILE RD SUITE 103 |
| City | WARREN |
| State | MI |
| Zip Code | 48093-3487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194720276 | Stuart R Gildenberg | Dermatology | 11900 E 12 Mile Rd, Ste 201, Warren, MI 48093-3490 | 2005-06-16 |
| 1902459159 | Tammy Jean Cass | Registered Nurse | 11900 E 12 Mile Rd, Warren, MI 48093-3400 | 2019-07-17 |
| 1437715026 | Dalia Hasso | Student in an Organized Health Care Education/Training Program | 11900 E 12 Mile Rd, Warren, MI 48093-3400 | 2019-05-19 |
| 1174070577 | Hayley Foster | Physician Assistant | 11900 E 12 Mile Rd, Suite 110, Warren, MI 48093-3400 | 2016-09-02 |
| 1063872877 | Andrew Cox | Physician Assistant | 11900 E 12 Mile Rd, Suite 110, Warren, MI 48093-3400 | 2016-03-07 |
| 1194115402 | Lingareddy Devireddy Md PC | Clinic/Center | 11900 E 12 Mile Rd, Suite 103, Warren, MI 48093-3400 | 2015-01-26 |
| 1538561469 | Erica Williams | Physician Assistant | 11900 E 12 Mile Rd, Suite 110, Warren, MI 48093-3400 | 2014-09-23 |
| 1578994737 | Mendelson Orthopedics | Orthopaedic Surgery | 11900 E 12 Mile Rd, Suite 105, Warren, MI 48093-3400 | 2013-12-12 |
| 1548542020 | Brittany J Miller | Physician Assistant | 11900 E 12 Mile Rd, Suite 100, Warren, MI 48093-3400 | 2011-09-12 |
| 1285916825 | Theresa Jeanette Richardson | Physician Assistant | 11900 E 12 Mile Rd, Suite 100, Warren, MI 48093-3400 | 2011-09-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615986 | Toleka Regina Taylor | Nurse Anesthetist, Certified Registered | St. John Macomb Hospital, 11800 East 12 Mile Road, Warren, MI 48093 | 2020-10-05 |
| 1679112676 | Open Heart Communities | Case Management | 31310 Shaw Dr, Warren, MI 48093 | 2019-12-23 |
| 1538715636 | 3 Dove Medical Supplies | Durable Medical Equipment & Medical Supplies | 31201 Chicago Rd S Ste C101, Warren, MI 48093 | 2019-08-14 |
| 1568954600 | Schreiber Cardiology, P.C. | Internal Medicine | 8545 Common Rd Ste 150, Warren, MI 48093 | 2018-06-05 |
| 1730686197 | Lambro Seremetis | Social Worker | 12200 E. 12 Mile Road, Ste. 200, Warren, MI 48093 | 2018-04-11 |
| 1649775826 | Ridge Downs | Behavioral Analyst | 31201 Chicago Rd South, Suite C- 202, Warren, MI 48093 | 2018-03-28 |
| 1144722737 | Jessica Farraj | Occupational Therapist | 11800 E. 12 Mile Road, Warren, MI 48093 | 2018-02-28 |
| 1265930168 | Leah Hanrahan | Registered Nurse | 11700 Amberle Dr., Warren, MI 48093 | 2018-01-25 |
| 1598271553 | Pamela Marie Confer | Occupational Therapist | 11012 13 Mile Rd, Suite 200, Warren, MI 48093 | 2017-12-28 |
| 1831604347 | Kate Jeanne Szczepanski | Behavior Technician | 31200 Chicago Rd S, Warren, MI 48093 | 2017-12-06 |
| Find all providers in zip 48093 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184893471 | Vijay B Behari Md Inc | Internal Medicine | 1700 East Market St, Suite 101, Warren, OH 44483-6625 | 2008-02-21 |
| 1417936238 | Larry A Woods | Internal Medicine | 9375 E Market St Ste 3, Warren, OH 44484-5552 | 2006-01-11 |
| 1487636684 | Inderjit Aggarwal | Internal Medicine | 29610 Ryan Rd, Warren, MI 48092-4247 | 2005-11-15 |
| 1528058773 | Theodore L Schreiber | Internal Medicine | 8545 Common Road, Ste 150, Warren, MI 48093 | 2005-10-27 |
| 1144219684 | Robert K Moore | Internal Medicine | 28341 Hoover Rd, Warren, MI 48093-4151 | 2005-10-18 |
| 1326032590 | Cardiac Management Inc | Internal Medicine | 1753 E Market St, Suite 1, Warren, OH 44483-6672 | 2005-09-02 |
| 1558363119 | Kyung Soo Kim | Internal Medicine | 14049 E 13 Mile Rd Ste 1, Warren, MI 48088-5876 | 2005-08-12 |
| 1093296592 | Pioneer Medical Associates P.C. | Internal Medicine | 27560 Hoover Rd, Warren, MI 48093 | 2018-08-23 |
| 1194031682 | Robert K Moore Md PC | Internal Medicine | 28341 Hoover Rd, Warren, MI 48093-4151 | 2010-08-23 |
| 1376797217 | Oakland Medical Group PC | Internal Medicine | 11900 E 12 Mile Rd, Suite 300, Warren, MI 48093-3400 | 2008-11-05 |
| Find all providers in WARREN | ||||
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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.