Individual
PAVAN K THANGUDU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4300 LONDONDERRY RD, HARRISBURG, PA 17109-5317
(717) 231-8772
(717) 231-8435
Mailing address
21 SPURS LN, STE 230B, SAN ANTONIO, TX 78240-1671
(210) 690-7400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD457573
PA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
R1661
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103118689
—
PA
Enumeration date
03/31/2010
Last updated
08/08/2017
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