Organization
LARAMIE PEDIATRICS/LARAMIE INTERNAL MEDICINE PC
Active
Parent organization
LARAMIE PEDIATRICS/LARAMIE INTERNAL MEDICINE PC
Other names
Dell Range Pediatrics
Organization subpart
Yes
Provider details
NPI number
Legal business name
LARAMIE PEDIATRICS/LARAMIE INTERNAL MEDICINE PC
Authorized official
VIJAYA MADHAVI KODURI M.D (OWNER)
(307) 365-8789
Entity
Organization
Contact information
Practice address
1252 N. 22ND STREET, SUITE B, LARAMIE, WY 82072
(307) 745-3704
Mailing address
1252 N. 22ND STREET, SUITE B, LARAMIE, WY 82072
(307) 745-3704
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558672253
—
WY
Enumeration date
10/13/2016
Last updated
03/05/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us