Individual
SUJAN KUMAR VADAREVU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1410 N 4TH ST, CLINTON, IA 52732-2940
(563) 244-5555
Mailing address
1410 N 4TH ST, CLINTON, IA 52732-2940
(563) 244-5555
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD-41937
IA
208M00000X
Hospitalist Physician
Primary
MD-41937
IA
Other
Enumeration date
07/01/2010
Last updated
09/10/2014
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