Individual
DR. RAJIV MATTHEW MALLIPUDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610
(203) 384-4677
(203) 384-3135
Mailing address
20 YORK STREET, CB-2041, NEW HAVEN, CT 06510-3220
(203) 384-4677
(203) 384-3135
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
62105
CT
208M00000X
Hospitalist Physician
Primary
62105
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2016
Last updated
02/26/2020
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