Individual
PUSHPA ALLAM-NANDYALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11375 CORTEZ BLVD, OAK HILL HOSPITAL, BROOKSVILLE, FL 34613-5409
(352) 596-6632
Mailing address
11375 CORTEZ BLVD, OAK HILL HOSPITAL, BROOKSVILLE, FL 34613-5409
(352) 596-6632
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME72587
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14E74
BCBS OF FL
FL
Enumeration date
06/17/2009
Last updated
12/22/2011
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