Individual
DEEPTI PIDAKALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
5322 US HIGHWAY 158, ADVANCE, NC 27006-6907
(336) 940-5515
Mailing address
1149 CLYDE EDGERTON DR, KERNERSVILLE, NC 27284-7972
(336) 793-7052
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28172
NC
Other
Enumeration date
07/13/2019
Last updated
07/13/2019
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