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Individual

POOJITHA REDDY BERAVOL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3615 NW SAMARITAN DR, SUITE 203, CORVALLIS, OR 97330-3783
(541) 768-6930
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
1343
WI
207RN0300X
Nephrology Physician
Primary
MD171595
OR
207RN0300X
Nephrology Physician
MD60697665
WA

Other

Enumeration date
06/01/2009
Last updated
03/21/2022
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