Provider Demographics
NPI:1295197705
Name:KANIPAKAM, RAKESH (MD)
Entity type:Individual
Prefix:DR
First Name:RAKESH
Middle Name:
Last Name:KANIPAKAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2034 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1111
Mailing Address - Country:US
Mailing Address - Phone:334-269-0212
Mailing Address - Fax:334-269-2144
Practice Address - Street 1:2034 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1111
Practice Address - Country:US
Practice Address - Phone:334-269-0212
Practice Address - Fax:334-269-2144
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-23
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.46579207RN0300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty