VIJAY KUMAR DAMARLA (NPI# 1669762795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669762795 |
| Entity Type | Individual |
| Full Name | VIJAY KUMAR DAMARLA |
| Other Name | VENKATA DARMA VEERA VIJAY KUMAR DAMARLA |
| Credential | MD |
| Practice Address |
210 W Mckinley Ave Ste 1 Decatur IL 62526 |
| Mailing Address |
210 W Mckinley Ave Ste 1 Decatur IL 62526-5858 |
| Practice Telephone | 2178766600 |
| Practice Fax Number | 2178766606 |
| Mailing Telephone | 2178766600 |
| Mailing Fax Number | 2178766606 |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2019-01-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
036146175 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
210 W MCKINLEY AVE STE 1 |
| City | DECATUR |
| State | IL |
| Zip Code | 62526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114913225 | Thomas H Tarter | Surgery | 210 W Mckinley Ave Ste 1, Decatur, IL 62526-5858 | 2005-09-23 |
| 1588133003 | Christel Gayle Wheeler | Nurse Practitioner | 210 W Mckinley Ave Ste 1, Decatur, IL 62526-5858 | 2018-11-14 |
| 1558566984 | Harold A Yoon | Radiology | 210 W Mckinley Ave Ste 1, Decatur, IL 62526-5858 | 2007-06-16 |
| 1275502940 | Benjamin T Esparaz | Internal Medicine | 210 W Mckinley Ave Ste 1, Decatur, IL 62526-5858 | 2006-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578755815 | Oncology Specialties, PC | Internal Medicine | 310 8th Ave Se, Decatur, AL 35601 | 2007-08-10 |
| 1134291792 | Southeast Cancer Network, Inc. | Internal Medicine | 1107 14th Ave Se Ste 200, Decatur, AL 35601-3354 | 2006-11-15 |
| 1497726137 | Sammy F Becdach | Internal Medicine | 1107 14th Ave Se, Plaza II Suite 200, Decatur, AL 35601-3309 | 2006-01-31 |
| 1063412567 | Aaron R Alizadeh | Internal Medicine | 2712 Lawrenceville Hwy, Decatur, GA 30033-2512 | 2005-07-26 |
| 1053571091 | Dallas Oncology Consultants Pa | Internal Medicine | 2010 Ben Merritt Dr, Suite A, Decatur, TX 76234-3854 | 2008-06-12 |
| 1447437538 | Ana Gabriela Antun | Internal Medicine | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2008-01-30 |
| 1770769234 | Simbo Oluwabusuyi Aduloju | Internal Medicine | 2712 Lawrenceville Hwy, Decatur, GA 30033-2512 | 2008-01-15 |
| 1396876835 | Badi El Osta | Internal Medicine | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2007-03-08 |
| 1366549735 | Neelima Maddukuri | Internal Medicine | 2010 Ben Merritt Dr, Suite A, Decatur, TX 76234-3854 | 2006-09-20 |
| 1326152208 | Maria Ja Ribeiro | Internal Medicine | 1670 Clairmont Rd, Maistop 111, Decatur, GA 30033-4004 | 2006-08-18 |
| Find all providers in DECATUR | ||||
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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.