Basic Information
| Provider Information | |||||||||
| NPI: | 1851316673 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SRIPADA | ||||||||
| FirstName: | RAMPRASAD | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 HAWKINS DR | ||||||||
| Address2: | |||||||||
| City: | IOWA CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 522421009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193562633 | ||||||||
| FaxNumber: | 3193562940 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 HAWKINS DR | ||||||||
| Address2: | |||||||||
| City: | IOWA CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 522421009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193562633 | ||||||||
| FaxNumber: | 3193562940 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2006 | ||||||||
| LastUpdateDate: | 09/06/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 105718 | MO | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 40433 | IA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | 40433 | IA | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207LP3000X | 40433 | IA | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pediatric Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 1847 | 01 | BLUE CROSS BLUE SHIELD | OTHER | 250797 | 01 | HARMONY ID# | OTHER | 204760607 | 05 | MO | MEDICAID | 50071455 | 01 | MO | MEDICARE RAILROAD | OTHER | 7769021 | 01 | AETNA | OTHER | 75214 | 01 | HEALTH ALLIANCE | OTHER |