Penugonda, Dwaraki Bai
Penugonda, Dwaraki Bai is an sole proprietor health care provider with primary practice located at 166 Hanover St Suite 307, Wilkes Barre PA 18702-3549. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Penugonda, Dwaraki Bai can be contacted via phone (570) 823-8184.Contact Information
Primary practice address
166 Hanover St Suite 307
Wilkes Barre PA 18702-3549
Phone: (570) 823-8184
Fax: (570) 823-6460
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD035084Y | Pennsylvania |
Profile Details
| NPI number | 1386701357 |
|---|---|
| LBN Legal business name | Penugonda, Dwaraki Bai |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 2nd, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1386701357 | NPPES |
| Pennsylvania | MEDICAID | 0006538020001 |
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