Individual
PRIDVI GAUTHAM KANDAGATLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1983 SLOAN PL STE 11, SAINT PAUL, MN 55117-2004
(651) 312-1620
(651) 312-1570
Mailing address
4200 DAHLBERG DR STE 300, GOLDEN VALLEY, MN 55422-4841
(952) 512-5600
(952) 512-5651
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
71756
MN
Other
Enumeration date
04/03/2014
Last updated
11/21/2023
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