Individual
NISHANTH KODUMURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8 RICHLAND MEDICAL PARK DR STE 420, COLUMBIA, SC 29203-8004
(803) 434-8050
(803) 933-3005
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 533-8603
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
39923
SC
2084N0400X
Neurology Physician
LL39923
SC
Other
Enumeration date
07/28/2016
Last updated
10/21/2021
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