Individual
DR. BRAHMANANDA KIRAN KODURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
501 S BURMA AVE, GILLETTE, WY 82716-3426
(307) 688-1534
Mailing address
4516 RUNNING W DR APT 101, GILLETTE, WY 82718-2033
(609) 216-0537
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
9302A
WY
Other
Enumeration date
11/03/2009
Last updated
09/03/2013
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