Bandaru, Kiran Babu
Bandaru, Kiran Babu is an individual health care provider with primary practice located at 1235 E Cherokee St , Springfield MO 65804-2203. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Bandaru, Kiran Babu 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:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 2013017443 | Missouri |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 2013017443 | Missouri |
Profile Details
| NPI number | 1376721209 |
|---|---|
| LBN Legal business name | Bandaru, Kiran Babu |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 1st, 2008 |
| Last updated | May 8th, 2017 - about 8 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 | 1376721209 | NPPES |
| Missouri | Other | 431560263 | TRICARE |
| Missouri | Other | P01246683 | TRICARE |
| Missouri | MEDICAID | 1376721209 | TRICARE |
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