Individual
GIRIDHAR RAO VEERULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3919 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6811
(260) 436-7722
(260) 459-0012
Mailing address
3919 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6811
(260) 436-7722
(260) 459-0012
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01043132
IN
Other
Enumeration date
09/25/2006
Last updated
07/08/2007
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