Individual
KARTHIK KANNEGOLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403
(812) 676-4660
(812) 355-2751
Mailing address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 676-4660
(812) 355-2751
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301102865
MI
207RN0300X
Nephrology Physician
Primary
01076648A
IN
Other
Enumeration date
07/09/2013
Last updated
12/17/2020
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