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Individual
PRIYADARSINI PURAM
Active
Individual
PRIYADARSINI PURAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
270203
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110108343A
—
MA
Enumeration date
04/26/2014
Last updated
06/05/2020
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