Individual
DR. VIJAYA D L PRADEEPTHI MARRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.,
Contact information
Practice address
521 MOYE BLVD, GREENVILLE, NC 27834-2849
(252) 744-3229
(252) 744-3924
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125060446
IL
207R00000X
Internal Medicine Physician
Primary
2015-01672
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285916148
—
NC
01
—
19D22
BCBS NC
NC
Enumeration date
09/15/2011
Last updated
02/20/2024
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