Individual
VIJAYASIMHA REDDY POTHULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1825 LOGAN AVE, WATERLOO, IA 50703-1916
(319) 235-5386
(319) 235-3074
Mailing address
4150 KIMBALL AVE, PO BOX 2758, WATERLOO, IA 50701-9086
(319) 235-5390
(319) 233-1630
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
40239
IA
Other
Enumeration date
01/27/2009
Last updated
06/26/2012
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