Individual
MAHESWARA REDDY KOPPULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
651 DUNLOP LN, CLARKSVILLE, TN 37040
(931) 502-5090
(931) 502-5081
Mailing address
501 S WASHINGTON AVE STE 1000, SCRANTON, PA 18505-3805
(570) 343-2383
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
028172
OH
207R00000X
Internal Medicine Physician
Primary
58980
TN
207R00000X
Internal Medicine Physician
DR-0026718
DE
207R00000X
Internal Medicine Physician
MD477801
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100626230
—
KY
Enumeration date
07/16/2016
Last updated
07/02/2025
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