Individual
DR. KOLALA VASUDEVAMURTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1900 E MAIN ST, VA ILLIANA HCS, DANVILLE, IL 61832-5100
(217) 554-5495
Mailing address
3929 DAHOMA DR, INDIANAPOLIS, IN 46237-3842
(812) 340-1805
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01026022A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
036048860
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200191580
—
IN
Enumeration date
02/14/2006
Last updated
07/08/2007
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