Allam, Bala Sudhakar Reddy
Allam, Bala Sudhakar Reddy is an individual health care provider with primary practice located at 1235 E Cherokee St , Springfield MO 65804-2203. He recently has 3 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Allam, Bala Sudhakar Reddy can be contacted via phone (417) 820-2600.Contact Information
Primary practice address
1235 E Cherokee St
Springfield MO 65804-2203
Phone: (417) 820-2600
Fax: (417) 820-2100
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | MT189901 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 2010018938 | Missouri |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 2010018938 | Missouri |
Profile Details
| NPI number | 1104024231 |
|---|---|
| LBN Legal business name | Allam, Bala Sudhakar Reddy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 10th, 2007 |
| Last updated | May 8th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104024231 | NPPES |
| Other | 431560263 | TRICARE WEST | |
| MEDICAID | 183039001 | TRICARE WEST | |
| Other | P00852017 | TRICARE WEST | |
| MEDICAID | 1104024231 | TRICARE WEST |
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