Individual
PRIYADARSHINI GANGULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 DUFF AVE, AMES, IA 50010
(515) 239-6992
Mailing address
1215 DUFF AVE, AMES, IA 50010-5400
(515) 239-4418
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
45817
IA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/29/2016
Last updated
12/22/2020
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