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Shivendra Tangutoori, MD
Student in an Organized Health Care Education/Training Program in Harlan, Kentucky
NPI 1114605474

Shivendra Tangutoori is a Student in an Organized Health Care Education/Training Program based in Harlan, KY. Shivendra Tangutoori practices in Harlan, KY and has the professional credentials of MD. The NPI Number for Shivendra Tangutoori is 1114605474 and holds a License No. (Kentucky).

The current practice location address for Shivendra Tangutoori is 81 Ball Park Rd, Harlan, KY and can be reached out via phone at 606-573-8100.

Location: 81 Ball Park Rd, Harlan, KY, 40831-1792
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114605474
Provider Name
Shivendra Tangutoori
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
81 Ball Park Rd, Harlan, KY, 40831-1792
Phone Number
606-573-8100
Fax Number
Provider Enumeration Date
07/07/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
81 Ball Park Rd
City
Harlan
State
Kentucky
Zip
40831-1792
Phone Number
606-573-8100
Fax Number
person
Provider Business Mailing Address Details
Address
81 Ball Park Rd
City
Harlan
State
Kentucky
Zip
40831-1792
Phone Number
606-573-8100
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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