Individual
PRAMODH CHANUMOLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1468 MADISON AVE, NEW YORK, NY 10029-6508
(212) 241-0693
(715) 387-5434
Mailing address
2301 E FOREST ST APT 6, MARSHFIELD, WI 54449-2457
(346) 221-2311
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
88829
SC
207RN0300X
Nephrology Physician
88829
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/27/2017
Last updated
05/16/2023
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