Individual
KALYANA C. R. BODDAPATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1705 TARBORO ST SW, WILSON, NC 27893-3428
(252) 399-8040
Mailing address
PO BOX 708760, SANDY, UT 84070-8760
(801) 352-9500
(801) 352-7976
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2012-00019
NC
207R00000X
Internal Medicine Physician
4301089020
MI
208M00000X
Hospitalist Physician
Primary
2012-00019
NC
Other
Enumeration date
01/14/2010
Last updated
12/01/2022
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