Individual
SAI KIRAN GUDLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-2134
(843) 792-2575
Mailing address
11522 TURNING HAWK RD, CHARLOTTE, NC 28277-3639
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
LL89748
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2022
Last updated
06/23/2023
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