Individual
BHAKTAVATHSALA REDDY DANDOLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1707 W CHARLESTON BLVD, SUITE 160, LAS VEGAS, NV 89102-2351
(702) 671-5150
(702) 384-6493
Mailing address
1701 W CHARLESTON BLVD, SUITE 215, LAS VEGAS, NV 89102-2325
(702) 671-2395
(702) 382-5388
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
14614
NV
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
25MA06622600
NJ
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
C51992
CA
Other
Enumeration date
07/12/2007
Last updated
12/17/2013
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