Individual
DR. VIVEK A KODURI
Active
Individual
DR. VIVEK A KODURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
DR.0066641
CO
390200000X
Student in an Organized Health Care Education/Training Program
TL0006446
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029231
KAISER COMMERCIAL NUMBER
CO
Enumeration date
05/24/2017
Last updated
08/06/2021
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