DR. SIRISHA KONERU M.D. NPI 1578510343

NPI Information

NPI: 1578510343
Provider Name: DR. SIRISHA KONERU, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
4646 JOHN R ST
DETROIT, MI
ZIP 48201
Phone: (248) 894-6393
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DR. Sirisha Koneru, M.D. is a family medicine in Detroit, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Sirisha Koneru, M.D. NPI is 1578510343. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4646 JOHN R ST
DETROIT, MI
ZIP 48201-916
Phone: (248) 894-6393

The enumeration date for this NPI number is 5/27/2006 and was last updated on 4/5/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207PE0004X	Emergency Medicine	Emergency Medical Services	4301079920	MICHIGAN	No
2	207Q00000X	Family Medicine		4301079920	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	104478863	MEDICAID	MICHIGAN
2	SK079920	OTHER	MICHIGAN	BC/BS OF MICHIGAN
3	104482150	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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