Basic Information
| Provider Information | |||||||||
| NPI: | 1124383039 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUVVURI | ||||||||
| FirstName: | ABHIRAM | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1500 SW 10TH AVE | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666041301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7853545242 | ||||||||
| FaxNumber: | 7853546349 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 SW 10TH AVE | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 66604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7853545242 | ||||||||
| FaxNumber: | 7853546349 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2012 | ||||||||
| LastUpdateDate: | 08/09/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 2021027837 | MO | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207R00000X | 04-38104 | KS | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 04-38104 | KS | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 201115140A | 05 | KS | MEDICAID | 068002335 | 01 | KS | MEDICARE PTAN | OTHER |