Narayana Rao Adusumilli, MD
Individual provider Active NPI Internal Medicine Physician · Fulton, MO
NPI 1891706115 · NPPES record last updated Aug 20, 2009
Key facts
- NPI
- 1891706115
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MDR4B31 (MO)
- Practice address
- 600 East 5TH Street
Fulton State Hospital
Fulton, MO 65251 - Phone
- (573) 592-4100
- Fax
- (573) 592-3023
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MDR4B31 | MO | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MDR4B31 | MO | Yes |
Addresses
Primary practice location
600 East 5TH Street
Fulton State Hospital
Fulton, MO 65251
Mailing address
600 East 5TH Street
Fulton, MO 65251
Phone (573) 592-4100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201541026 | Medicaid | MO |
Other providers in Fulton, MO
All providers in Fulton, MO · Internal Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.