Individual
DHEERAJ PUPPALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 936-7372
(803) 936-4102
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 936-7372
(803) 936-4102
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125062174
IL
207R00000X
Internal Medicine Physician
51544
SC
208M00000X
Hospitalist Physician
Primary
51544
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
515446
—
SC
Enumeration date
07/13/2012
Last updated
10/14/2025
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