Basic Information
| Provider Information | |||||||||
| NPI: | 1467456707 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KARUMANCHI | ||||||||
| FirstName: | VEERAIAH | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 502 W. 29TH STREET | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5208849920 | ||||||||
| FaxNumber: | 5206824570 | ||||||||
| Practice Location | |||||||||
| Address1: | 502 W. 29TH STREET | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5208849920 | ||||||||
| FaxNumber: | 5206824132 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2005 | ||||||||
| LastUpdateDate: | 05/02/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | 16392 | AZ | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 273839 | 05 | AZ | MEDICAID |