Individual
ANITHA KODURU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
447 N BELAIR RD STE 104, EVANS, GA 30809
(706) 854-2180
(706) 854-2189
Mailing address
PO BOX 1705, AUGUSTA, GA 30903-1705
(706) 774-7263
(706) 774-7230
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
2013016211
MO
Other
Enumeration date
07/09/2009
Last updated
07/09/2018
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