Individual
VAMSI KRISHNA POTLURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(888) 584-7888
Mailing address
PO BOX 650859, DALLAS, TX 75265-0859
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
BP10077251
TX
2086S0129X
Vascular Surgery Physician
125.080062
IL
Other
Enumeration date
06/16/2021
Last updated
05/25/2022
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