Individual
DR. SOBHA R. KODURU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
150 BERGEN ST # UHH-245, NEWARK, NJ 07103
(973) 972-5672
(973) 972-0365
Mailing address
30 BERGEN STREET, BUILDING 12 ROOM 1205, NEWARK, NJ 07107-3000
(973) 972-0037
(973) 972-0743
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
48189
AZ
208M00000X
Hospitalist Physician
Primary
48189
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0595403
—
NJ
05
—
845863
—
AZ
Enumeration date
08/11/2010
Last updated
02/22/2022
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