Individual
KAVITHA THATIKONDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5980 W 71ST ST STE 102, INDIANAPOLIS, IN 46278-1785
(317) 388-0800
(317) 388-0805
Mailing address
5980 W 71ST ST STE 102, INDIANAPOLIS, IN 46278-1785
(317) 388-0800
(317) 388-0805
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
3/31/2013
NY
Other
Enumeration date
06/30/2010
Last updated
06/30/2010
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