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SRINIVAS R DURSHANAPALLI
Gender: MALE
NPI: 1710265434
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Last Updated: | 2013-04-12 | ||
Certification Date: |
Details
Name | Value | ||||||||
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NPI | 1710265434 | ||||||||
Enumeration Date | 2011-07-29 | ||||||||
NPI Type | 1 - Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address |
5811 N CYPRESS DR
APT#3405
PEORIA, IL 61615-3376 United States Phone: 203-215-4687 | Fax: View Map ![]() |
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Primary Practice Address |
1403 W GLEN AVE
PEORIA, IL 61614-4705 United States Phone: 309-692-4721 | Fax: View Map ![]() |
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