Individual
PRADEEP CHAKRAVARTHY BOLLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1333 TAYLOR ST STE 1C, COLUMBIA, SC 29201-2944
(803) 254-6391
(803) 799-0682
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
2014021713
MO
2084N0400X
Neurology Physician
Primary
85697
SC
Other
Enumeration date
12/08/2009
Last updated
07/27/2021
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