Basic Information
| Provider Information | |||||||||
| NPI: | 1811199227 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ESKAPALLI | ||||||||
| FirstName: | SWARUPA | ||||||||
| MiddleName: | RANI | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5909 | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972285909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5742736767 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 710 PARK PL | ||||||||
| Address2: | NEPHROLOGY PHYSICIANS LLC | ||||||||
| City: | MISHAWAKA | ||||||||
| State: | IN | ||||||||
| PostalCode: | 465453519 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5742736767 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2007 | ||||||||
| LastUpdateDate: | 04/02/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | RT1926 | NH | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207R00000X | 125051346. | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | 01069093A | IN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 201018410 | 05 | IN | MEDICAID |