Individual
DR. BALA GANGADHARA REDDY THATIGOTLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
210 ASHVILLE AVE, CARY, NC 27518-6676
(919) 350-7331
(919) 851-6757
Mailing address
4401 DOMINION CREST DR, APEX, NC 27523-6257
(646) 938-3785
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2022-03263
NC
208600000X
Surgery Physician
267683
NY
Other
Enumeration date
05/11/2008
Last updated
10/05/2023
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