Individual
DR. KAIVALYA DANDAMUDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 S 11TH ST STE 2170, PHILADELPHIA, PA 19107-4870
(215) 955-1096
(215) 503-3976
Mailing address
111 S 11TH ST STE 2170, PHILADELPHIA, PA 19107-4870
(215) 955-1096
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0116037781
VA
207RC0000X
Cardiovascular Disease Physician
Primary
HS000240L
PA
Other
Enumeration date
04/03/2023
Last updated
06/11/2026
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