Individual
BEULAH JYOTHY KODURU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 UNIVERSITY OF NEW MEXICO HOSPITAL MSC 10 5550, ALBUQUERQUE, NM 87131-5640
(505) 272-2111
Mailing address
6301 ALAMEDA BLVD NE UNIT 2007, ALBUQUERQUE, NM 87113-2587
(312) 909-7318
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.068685
IL
207R00000X
Internal Medicine Physician
Primary
MD2020-0643
NM
Other
Enumeration date
07/16/2016
Last updated
07/29/2020
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