Individual
DR. KAVYA KOPPULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
705 PLEASANT AVE S, PARK RAPIDS, MN 56470-1440
(218) 732-2800
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-8000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301103189
MI
207Q00000X
Family Medicine Physician
Primary
60483
MN
Other
Enumeration date
07/02/2013
Last updated
07/22/2016
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