| Sriraj T Kanungo, MD | |
|
6812 State Route 162 Ste 121, Maryville, IL 62062-8586 | |
| (618) 391-5690 | |
| (618) 391-5691 |
| Full Name | Sriraj T Kanungo |
|---|---|
| Gender | Male |
| Speciality | Nephrology |
| Experience | 24 Years |
| Location | 6812 State Route 162 Ste 121, Maryville, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548355621 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RN0300X | Internal Medicine - Nephrology | 2005018762 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Davita - Maryville Dialysis | Maryville, IL | Dialysis facility |
| Davita - Maryville Home Dialysis | Maryville, IL | Dialysis facility |
| Davita - Granite City Dialysis Center | Granite city, IL | Dialysis facility |
| Davita - Collinsville | Collinsville, IL | Dialysis facility |
| Anderson Hospital | Maryville, IL | Hospital |
| Community Hospital Of Staunton | Staunton, IL | Hospital |
| St Joseph's Hospital | Highland, IL | Hospital |
| Gateway Regional Medical Center | Granite city, IL | Hospital |
| Alton Memorial Hospital | Alton, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Anderson Medical Group Llc | 5193792018 | 118 |
| Entity Name | Anderson Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700807716 PECOS PAC ID: 5193792018 Enrollment ID: O20040910001137 |
| Mailing Address | Practice Location Address |
|---|---|
| Sriraj T Kanungo, MD 6810 State Route 162, Box 215, Maryville, IL 62062 Ph: (618) 391-6495 | Sriraj T Kanungo, MD 6812 State Route 162 Ste 121, Maryville, IL 62062-8586 Ph: (618) 391-5690 |
Mr. Eddie Lynn Paulk, D.O. Nephrology Medicare: Accepting Medicare Assignments Practice Location: 6812 State Route 162 Ste 21, Maryville, IL 62062 Phone: 618-288-5566 Fax: 618-288-4005 | |
Dr. Christopher Farrar, M.D. Nephrology Medicare: Accepting Medicare Assignments Practice Location: 6800 State Route 162, Maryville, IL 62062 Phone: 618-288-4095 Fax: 618-288-2984 | |
Syed M Arshad, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 2227 Vadalabene Dr, Suite 100, Maryville, IL 62062 Phone: 618-288-1140 | |
Dr. Willis Ko, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 6810 State Route 162 Ste 102b, Maryville, IL 62062 Phone: 618-288-4076 Fax: 618-288-4215 | |
Dr. Samir K Shah, M.D. Nephrology Medicare: Accepting Medicare Assignments Practice Location: 6810 State Route 162 Ste 102, Maryville, IL 62062 Phone: 618-288-4076 Fax: 618-288-4215 | |
Barbara Joy Foner, MD MPH FCCP ABSM Nephrology Medicare: Accepting Medicare Assignments Practice Location: 6812 State Rte 162 Suite 202, Maryville, IL 62062 Phone: 618-288-6844 Fax: 618-288-6852 | |
Dr. Henry Purcell, M.D. Nephrology Medicare: Accepting Medicare Assignments Practice Location: 6812 State Route 162 Ste 121, Maryville, IL 62062 Phone: 618-391-6910 |