Individual
CHAKRAVARTHY KANDURU
Active
Individual
CHAKRAVARTHY KANDURU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
071718
MI
207RG0100X
Gastroenterology Physician
Primary
071718
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100H264400
BLUE CROSS-BLUE CROSS
—
05
—
426710710
—
MI
01
—
CK071718
CHAMPUS-CHAMPUS
—
Enumeration date
12/06/2006
Last updated
08/17/2012
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