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MADDALITHIRUMALA S CHARYALU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2001 VAIL AVE FL 7, CHARLOTTE, NC 28207-1219
(314) 317-0600
(314) 317-0606
Mailing address
12125 WOODCREST EXECUTIVE DR, SUITE 220, SAINT LOUIS, MO 63141-5001
(314) 317-0600
(314) 317-0606

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2009-00699
NC
208M00000X
Hospitalist Physician
2009-00699
NC

Other

Enumeration date
04/30/2009
Last updated
04/30/2009
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