Individual
MARKANDEYA MADABATTULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 HOSPITAL DR # DC043.00, COLUMBIA, MO 65212-1000
(573) 884-9066
Mailing address
624 LEGER WAY, EDMONTON, ALBERTA T6R 0-C2
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2017021066
MO
Other
Enumeration date
06/22/2017
Last updated
06/19/2020
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