Individual
MR. KISHORE B KONDAPANENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
690 S TRUMBULL, BAY CITY, MI 48708
(989) 922-4900
(989) 922-4911
Mailing address
690 S TRUMBULL, BAY CITY, MI 48708
(989) 922-4900
(989) 922-4911
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301058857
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2602960690
HEALTH PLUS
—
01
—
260Z910350
BCBS
MI
05
—
4318064
—
MI
01
—
5972098
AETNA
—
01
—
90196
BCBS
MI
01
—
N34080004
MEDICARE
MI
Enumeration date
08/02/2006
Last updated
02/15/2013
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