Provider Demographics
NPI:1053556167
Name:KORIMILLI, ANNAPURNA (MD)
Entity type:Individual
Prefix:
First Name:ANNAPURNA
Middle Name:
Last Name:KORIMILLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 525
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-0525
Mailing Address - Country:US
Mailing Address - Phone:610-933-8000
Mailing Address - Fax:
Practice Address - Street 1:420 W LINFIELD TRAPPE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-4278
Practice Address - Country:US
Practice Address - Phone:484-938-4030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-04
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425031207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAI21298Medicare UPIN
PA1053556167Medicare PIN