Individual
NAFISA B KONDRU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
167 W MAIN RD STE D, CONNEAUT, OH 44030-2057
(440) 593-5014
(440) 593-6037
Mailing address
24701 EUCLID AVE, EUCLID, OH 44117-1714
(440) 593-5014
(440) 593-6037
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35063531
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0887349
—
OH
Enumeration date
09/16/2006
Last updated
08/25/2011
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