Individual
VINAYA CHANDRA MADDUKURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1350 S KINGS DR, CHARLOTTE, NC 28207-2134
(704) 446-1242
(704) 446-1241
Mailing address
PO BOX 601372, CHARLOTTE, NC 28260-1372
(704) 446-1242
(704) 446-1241
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2011-00258
NC
207R00000X
Internal Medicine Physician
35.088133
OH
207R00000X
Internal Medicine Physician
36114942
IL
207RG0100X
Gastroenterology Physician
2011-00258
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770512774
—
NC
05
—
200844300
—
IN
05
—
2697121
—
OH
05
—
4047833
—
TN
05
—
5920649
—
NC
05
—
64127996
—
KY
05
—
NC1630
—
SC
Enumeration date
07/02/2006
Last updated
11/29/2016
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