Individual
DR. VIJAYA MADHAVI KODURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBBS
Contact information
Practice address
1252 N 22ND ST, LARAMIE, WY 82072-5306
(307) 745-3704
(307) 745-7237
Mailing address
PO BOX 3046, GILLETTE, WY 82717-3046
(307) 688-2600
(307) 685-3079
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9303A
WY
Other
Enumeration date
06/28/2010
Last updated
08/31/2023
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