Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shivendra Tangutoori, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1114605474

Shivendra Tangutoori, MD is a Student in an Organized Health Care Education/Training Program in Harlan, Kentucky. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

81 Ball Park Rd
Harlan, KY 40831-1792
Phone: (606) 573-8100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1114605474
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 7, 2023
Last updated in NPPESJuly 7, 2023
Certification dateJuly 7, 2023

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