Individual
FERNANDO THADEPALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
43458
MN
207R00000X
Internal Medicine Physician
Primary
DR.0059540
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000164657
—
CO
Enumeration date
12/30/2005
Last updated
09/30/2021
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