Individual
PALLAVI KOPPARTHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
23 SUNNYBROOK RD STE 220, RALEIGH, NC 27610-1855
(919) 350-2873
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0351
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
2022-02587
NC
207RH0003X
Hematology & Oncology Physician
76250
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285045500
—
NC
05
—
1285045500
—
WI
Enumeration date
05/09/2014
Last updated
10/18/2022
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