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Individual
DR. PRAVEEN DANDAMUDI
Active
Individual
DR. PRAVEEN DANDAMUDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125049524
IL
207R00000X
Internal Medicine Physician
52782
TN
207RN0300X
Nephrology Physician
Primary
52782
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6046839
BCBS
TN
05
—
7100358320
—
KY
05
—
Q013761
—
TN
Enumeration date
01/18/2008
Last updated
09/12/2024
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