Individual
ADITHYA CHENNAMADHAVUNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 550-4795
Mailing address
PO BOX 255228, SACRAMENTO, CA 95865-5228
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD44246
IA
207RH0003X
Hematology & Oncology Physician
Primary
C175046
CA
207RH0003X
Hematology & Oncology Physician
MD44246
IA
208M00000X
Hospitalist Physician
MD-44246
IA
Other
Enumeration date
07/23/2014
Last updated
07/21/2023
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