Individual
HARITHA BOPPANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
701 GROVE RD FL 5, GREENVILLE, SC 29605
(864) 455-4411
(864) 455-4480
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
32786
SC
208M00000X
Hospitalist Physician
Primary
32786
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
327863
—
SC
05
—
89138C7
—
NC
Enumeration date
06/17/2005
Last updated
10/26/2021
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