1245722842 NPI number — ASHOK MADDUKURI MD

Table of content: ASHOK MADDUKURI MD (NPI 1245722842)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245722842 NPI number — ASHOK MADDUKURI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MADDUKURI
Provider First Name:
ASHOK
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245722842
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/20/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PENN STATE HEALTH MILTON S. HERSHEY MEDICAL CENTER
Provider Second Line Business Mailing Address:
500 UNIVERSITY DRIVE
Provider Business Mailing Address City Name:
HERSHEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17033
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-243-1455
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PENN STATE HEALTH MILTON S. HERSHEY MEDICAL CENTER
Provider Second Line Business Practice Location Address:
500 UNIVERSITY DRIVE
Provider Business Practice Location Address City Name:
HERSHEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
175-318-0247
Provider Business Practice Location Address Fax Number:
717-531-0882
Provider Enumeration Date:
05/31/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  MD485621 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)